Atypia / premalignant / preinvasive lesions
HSIL / CIN II / moderate dysplasia
Reviewer: Marilin Rosa, M.D., University of Florida (see Reviewers page)
Revised: 8 June 2011, last major update June 2011
Copyright: (c) 2006-2011, PathologyOutlines.com, Inc.
● CIN II / moderate dysplasia is classified as HSIL
● Mean reporting rate of HSIL in US laboratories was 0.5% (Arch Pathol Lab Med 2004;128:1224); 2% of women with HSIL at cytology have invasive cancer after further evaluation
● Due to infecton by high risk HPV
● Cases with a few moderately dysplastic cells may have either LSIL or HSIL at followup, which cannot be predicted
(Diagn Cytopathol 2000;23:245)
● Colposcopy, then as appropriate
● Cell size is same as squamous metaplastic or parabasal cells; polygonal shape (like intermediate or superficial cell), denser cytoplasm
● N/C ratio is 1/3 to 1/2
● Enlarged and hyperchromatic nucleus
● Nuclear membranes may be irregular (crinkled paper)
● No nucleoli
● Check for variation in nuclear size at basal layer
Possible CIN II
● Atrophy, immature squamous metaplasia (College of American Pathologists Practical Guide to Gynecologic Cytopathology. Morphology, Management, and Molecular Methods)
End of Cervix-cytology > Atypia / premalignant / preinvasive lesions > HSIL / CIN II / moderate dysplasia
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