Premalignant / preinvasive lesions - H&E

Atypical squamous lesion

Topic Completed: 6 October 2003

Minor changes: 16 November 2020

Copyright: 2003-2021, PathologyOutlines.com, Inc.

PubMed search: Atypical squamous lesion of cervix

Nat Pernick, M.D.
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Cite this page: Pernick N. Atypical squamous lesion. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixatypicalsquamouslesion.html. Accessed December 3rd, 2021.
Definition / general
  • Terminology more appropriate for cytology than for biopsy specimens
  • May be reactive or neoplastic (HPV related, LSIL, HSIL)
  • In cervical smears, often related to SIL
Features Suggesting Reactive or Neoplastic
Features suggestive of neoplasia (5 or more) vs. reactive (0 - 2) are:
  • Mitotic figures
  • Vertical nuclear growth pattern
  • No perinuclear halo
  • Indistinct cytoplasmic border
  • Primitive cells in upper 1/3 of squamous layer
  • p16+ cells in upper 2/3 of squamous layer
  • Ki67+ cells in upper 2/3 of squamous layer (Am J Clin Pathol 2005;123:699)

Reactive changes are present in 2 - 3% of cervical smears and include:
  • Normal N/C ratio
  • Intercellular bridges
  • Regular nuclear membrane
  • Finely granular chromatin and prominent nucleoli but no organization disruption
  • No/rare mitotic figures
  • No abnormal mitotic figures
  • May be occasional binucleated cells or neutrophils in epithelium
Microscopic (histologic) images

AFIP images

Normal architecture and polarity

Prominent nucleoli

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