Low-grade squamous intraepithelial lesion - Revision history

Michael at 14:29, 6 May 2016

2016-05-06T14:29:14Z

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	{{ Infobox diagnosis		{{ Infobox diagnosis
	\| Name = {{PAGENAME}}		\| Name = {{PAGENAME}}
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	'''Low-grade squamous intraepithelial lesion''', abbreviated '''LSIL''', is a pre-cancerous lesions of the [[uterine cervix]].		'''Low-grade squamous intraepithelial lesion''', abbreviated '''LSIL''', is a pre-cancerous lesions of the [[uterine cervix]].

	Increasingly, the term is being applied to other anatomical sites, e.g. [[vagina]].		Increasingly, the term is being applied to other anatomical sites, e.g. [[vagina]], [[anal intraepithelial lesions\|anus]].

	It is in the larger category of '''[[Squamous intraepithelial lesion of the uterine cervix\|squamous intraepithelial lesion]]''', abbreviated '''SIL'''.		It is in the larger category of '''[[Squamous intraepithelial lesion of the uterine cervix\|squamous intraepithelial lesion]]''', abbreviated '''SIL'''.

Michael: touch

2015-03-31T05:29:37Z

touch

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	{{ Infobox diagnosis		{{ Infobox diagnosis
	\| Name = {{PAGENAME}}		\| Name = {{PAGENAME}}
	\| Image = Low-grade squamous intraepithelial lesion -- high mag.jpg		\| Image = Low-grade squamous intraepithelial lesion -- high mag.jpg
	\| Width =		\| Width =
	\| Caption = LSIL. [[H&E stain]].		\| Caption = LSIL. [[H&E stain]].

Michael: /* References */

2014-10-20T06:19:36Z

References

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	==References==		==References==
	{{Reflist\|2}}		{{Reflist\|2}}

			==External links==
			*[http://www.medecine.ups-tlse.fr/dcem1/histologie/courtade/CINtec.pdf Interpretation altas for p16 staining (ups-tlse.fr)].

	[[Category:Uterine cervix]]		[[Category:Uterine cervix]]
	[[Category:Diagnosis]]		[[Category:Diagnosis]]

Michael: /* Images */

2014-05-27T11:48:48Z

Images

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	www:		www:
	*[http://www.flickr.com/photos/jian-hua_qiao_md/3987000055/ CIN 1 (flickr.com/Qiao)].		*[http://www.flickr.com/photos/jian-hua_qiao_md/3987000055/ CIN 1 (flickr.com/Qiao)].
			*[https://www.flickr.com/photos/jian-hua_qiao_md/3986999903/ CIN 1 (flickr.com/Qiao)].
	*[http://www.eurocytology.eu/static/eurocytology/eng/cervical/mod6img1a.html CIN 1 (eurocytology.eu)].		*[http://www.eurocytology.eu/static/eurocytology/eng/cervical/mod6img1a.html CIN 1 (eurocytology.eu)].

Michael: /* CIN 1 */

2014-04-11T18:16:17Z

CIN 1

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	<pre>		<pre>
	COMMENT:		COMMENT:
	A p16 immunostain is strong and diffuse in the lower aspect of squamous epithelium, and weak and patchy in the superficial portions; this is compatible with LSIL.		A p16 immunostain is strong and diffuse in the lower aspect of squamous epithelium,
			and weak and patchy in the superficial portions; this is compatible with LSIL.
	</pre>		</pre>

Michael: /* ECC - cannot grade */ fix sp.

2014-03-10T12:56:24Z

ECC - cannot grade: fix sp.

← Older revision		Revision as of 12:56, 10 March 2014
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	<pre>		<pre>
	UTERINE CERVIX, BIOPSY:		UTERINE CERVIX, BIOPSY:
	- ~~FRAGEMENTS~~ OF SQUAMOUS EPITHELIUM SHOWING DYSPLASIA, SEE COMMENT.		- FRAGMENTS OF SQUAMOUS EPITHELIUM SHOWING DYSPLASIA, SEE COMMENT.

	COMMENT:		COMMENT:

Michael: /* Sign-out */

2014-03-07T21:01:22Z

Sign-out

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	to distinguish low-grade from high-grade in this specimen. That said,		to distinguish low-grade from high-grade in this specimen. That said,
	there is at least low grade-dysplasia. Follow-up is recommended with		there is at least low grade-dysplasia. Follow-up is recommended with
			re-biopsy if clinically indicated.
			</pre>

			===Biopsy - cannot grade===
			<pre>
			UTERINE CERVIX, BIOPSY:
			- AT LEAST LOW-GRADE SQUAMOUS INTRAEPITHELIAL LESION (LSIL), SEE COMMENT.
			- BENIGN ENDOCERVICAL EPITHELIUM.

			COMMENT:
			A concerning area of dysplastic squamous epithelium is missing its surface cells. This
			precludes assessment for a high-grade lesion. Follow-up is recommended with
	re-biopsy if clinically indicated.		re-biopsy if clinically indicated.
	</pre>		</pre>

Michael: /* Cervical biopsy */

2014-03-07T19:07:49Z

Cervical biopsy

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	The Ki-67 positive cells are confined to the lower aspect of the squamous epithelium.		The Ki-67 positive cells are confined to the lower aspect of the squamous epithelium.
	A p16 stain is negative.		A p16 stain is negative.
			</pre>

			<pre>
			COMMENT:
			A p16 immunostain is strong and diffuse in the lower aspect of squamous epithelium, and weak and patchy in the superficial portions; this is compatible with LSIL.
	</pre>		</pre>

Michael: /* Microscopic */

2014-01-31T12:25:28Z

Microscopic

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	Features:<ref name=Ref_PBoD1075-6>{{Ref PBoD\|1075-6}}</ref>		Features:<ref name=Ref_PBoD1075-6>{{Ref PBoD\|1075-6}}</ref>
	*"Koilocytic atypia":<ref name=Ref_GP146>{{Ref GP\|146}}</ref>		*"Koilocytic atypia":<ref name=Ref_GP146>{{Ref GP\|146}}</ref>
	**~~Cytoplasmic~~ halos.		**Clear cytoplasmic halos (perinuclear clearing).
	**Nuclear enlargement >=3:1 enlarged nucleus:normal nucleus.		**Nuclear enlargement.
	**Nuclear membrane irregularities.		***Classically >=3:1 enlarged nucleus:normal nucleus.
	**Nuclear hyperchromasia.		***May be mild (superficial cells = size of basal cells).
			**Nuclear membrane irregularities - '''important'''.
			**Nuclear hyperchromasia - '''important'''.
	**Coarse chromatin.		**Coarse chromatin.
	**Binucleation may be seen (cytopathic effect of [[HPV]]).<ref name=pmid11491378>{{cite journal \|author=Roteli-Martins CM, Derchain SF, Martinez EZ, Siqueira SA, Alves VA, Syrjänen KJ \|title=Morphological diagnosis of HPV lesions and cervical intraepithelial neoplasia (CIN) is highly reproducible \|journal=Clin Exp Obstet Gynecol \|volume=28 \|issue=2 \|pages=78–80 \|year=2001 \|pmid=11491378 \|doi= \|url=}}</ref>		**+/-Binucleation may be seen (cytopathic effect of [[HPV]]).<ref name=pmid11491378>{{cite journal \|author=Roteli-Martins CM, Derchain SF, Martinez EZ, Siqueira SA, Alves VA, Syrjänen KJ \|title=Morphological diagnosis of HPV lesions and cervical intraepithelial neoplasia (CIN) is highly reproducible \|journal=Clin Exp Obstet Gynecol \|volume=28 \|issue=2 \|pages=78–80 \|year=2001 \|pmid=11491378 \|doi= \|url=}}</ref>
			***Useful when present.

	Note:		Note:
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	Koilocytes:		Koilocytes:
	*Perinuclear clearing.		*Perinuclear clearing.
	*Nuclear changes.		**Halo should be crystal clear.
			*Nuclear changes - '''key feature'''.
	**Size similar (or larger) to those in the basal layer of the epithelium.		**Size similar (or larger) to those in the basal layer of the epithelium.
	**Nuclear enlargement should be evident on low power, i.e. 25x. <ref>V. Dube 2008.</ref>		***Nuclear enlargement should be evident on low power, i.e. 25x.<ref>V. Dube 2008.</ref>
	**Central location - nucleus should be ~~smack~~ in the middle of the cell.		**Nuclear hyperchromasia.
			**Central location - nucleus should be in the middle of the cell.
	~~Notes:~~		***Benign cells have a small nucleus that is peripheral.
	~~# Both perinuclear clearing and nuclear changes are essential.~~
	# Benign cells have a small nucleus that is peripheral.

	===Images===		===Images===

Michael at 20:44, 30 January 2014

2014-01-30T20:44:57Z

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	\| Syndromes =		\| Syndromes =
	\| Clinicalhx =		\| Clinicalhx =
	\| Signs = acetowhite ~~positive~~ lesion		\| Signs = [[acetowhite lesion]]
	\| Symptoms =		\| Symptoms =
	\| Prevalence = common		\| Prevalence = common