Premalignant / preinvasive lesions - cytology

HSIL / CIN II (cyto)

Topic Completed: 1 June 2011

Minor changes: 5 July 2020

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PubMed search: HSIL CIN II moderate dysplasia

Marilin Rosa, M.D.
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Cite this page: Rosa M. HSIL / CIN II (cyto). PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixcytologyHSILCINII.html. Accessed September 22nd, 2021.
  • 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
Clinical features
  • 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
Cytology description
  • 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
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