Cervical
Intraepithelial Neoplasm
Common sites:
Gross features:
- raised lesions (acuminatum) are associated with low-risk HPVs
- flat lesions are
associated with high-risk HPVs
Histologic features:
- cytologic atypia:
- hyperchromatic nuclei
- nuclear pleomorphism
- increased n:c ratio
- irregular
nuclear borders
- coarse, granular
(salt and pepper), or filamentous
- CIN I (LSIL):
- Atypical basaloid cells occupying lower third of epithelium
- Often
indistinguishable from condylomata acuminata
- HPV cytopathic effect in superficial epithelial cells (koilocytosis):
- Nuclear
enlargement, hyperchromasia, pleomorphism, and multinucleation
- raisinoid
or binuclear
- Cytoplasmic halos (koilocytic
atypia)
- Few alterations
in the lower epithelial cells
- CIN II (HSIL):
- Atypical basaloid cells occupying up to the middle third of
epithelium
- Increased
mitoses and abnormal mitoses, but confined to lower two thirds
- Nuclear crowding
- Loss of normal
cell polarity
- Indistinct cell
borders
- Persistent
differentiation toward prickle and keratinizing cell layers
- CIN III (HSIL):
- Atypical basaloid cells occupying the top third of the
epithelium or entire epithelium
- Mitoses or
abnormal mitoses seen in top third of epithelium
Immunophenotype:
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Marker:
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Sensitivity:
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Specificity:
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Molecular features:
Other features: