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The London (cytology) criteria - 2 of 3:
- Perinuclear clearing.
- Membrane irregularities (5 cells in one field - FD ~ 1.1 mm).
- Nuclear enlargement > 2x lymphocyte.
Augmented (London) criterium includes:
- Neoplastic transisition (sharp transisition from normal to abnormal - gradient over 2-3 cell distance).
Required if #3 not obvious:
- Binucleation (>2 cells).
- Nucleoli ( >5 in one field - FD ~ 1.1 mm).
- Cytoplasm to nucleus ratio =< 2:1; HSIL or invasive SCC.
Cannot exclude HSIL
UTERINE ENDOCERVIX, CURETTAGE: - VERY SMALL FRAGMENTS WITH AT LEAST LOW-GRADE SQUAMOUS INTRAEPITHELIAL LESION (LSIL), SEE COMMENT. - STRIPPED ENDOCERVICAL EPITHELIUM WITHOUT APPARENT PATHOLOGY. COMMENT: The morphology is more in keeping with LSIL; however, a p16 stain shows strong diffuse staining, as may be seen in the basal cells of a LSIL or a high-grade squamous intraepithelial lesion (HSIL). HSIL cannot be excluded.
Secretory phase endometrial epithelium vs endocervical epithelium
- Narrower columnar cells/taller.
- Nuclei more cigar like.
- Paler cytoplasm.
- Wider cells.
- Nuclei rounder.
- Link pink cytoplasm.