10. Management of histologically confirmed high-grade squamous abnormalities

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Introduction

According to the two-tiered nomenclature for cervical histology recommended by the Lower Anogenital Squamous Terminology (LASTLower Anogenital Squamous Terminology) standardization project[1] and adopted by the Royal College of Pathologists of Australasia, non-invasive human papillomavirus (HPVHuman papillomavirus)-associated squamous lesions are classified as:

  • LSIL: low-grade squamous intraepithelial lesion
  • HSILHigh-grade squamous intraepithelial lesionIn the Australian context, HSIL is used to refer to a cytology predictive of a high grade precancerous lesion (AMBS 2004), or histologically confirmed high grade precancerous lesion (HSIL-CIN2 or HSIL-CIN3 as per LAST terminology).: high-grade squamous intraepithelial lesion

HSILHigh-grade squamous intraepithelial lesionIn the Australian context, HSIL is used to refer to a cytology predictive of a high grade precancerous lesion (AMBS 2004), or histologically confirmed high grade precancerous lesion (HSIL-CIN2 or HSIL-CIN3 as per LAST terminology). can be further subcategorised, according to the grade of cervical intraepithelial neoplasia (CINCervical Intraepithelial NeoplasiaRefers to abnormal changes in the cells on the surface of the cervix that are seen using a microscope (i.e. histologically-confirmed).CIN 1 – Mild dysplasiaCIN 2 – Moderate dysplasiaCIN 3 – Severe dysplasia to carcinoma in situ(The term CIN 2+ refers to CIN 2, 3, or invasive cervical cancer; CIN3+ refers to CIN 3 or invasive cervical cancer)CIN 2/3 refers to CIN 2 or CIN 3.), as HSILHigh-grade squamous intraepithelial lesionIn the Australian context, HSIL is used to refer to a cytology predictive of a high grade precancerous lesion (AMBS 2004), or histologically confirmed high grade precancerous lesion (HSIL-CIN2 or HSIL-CIN3 as per LAST terminology). (CIN2) and HSILHigh-grade squamous intraepithelial lesionIn the Australian context, HSIL is used to refer to a cytology predictive of a high grade precancerous lesion (AMBS 2004), or histologically confirmed high grade precancerous lesion (HSIL-CIN2 or HSIL-CIN3 as per LAST terminology). (CIN3).

HSILHigh-grade squamous intraepithelial lesionIn the Australian context, HSIL is used to refer to a cytology predictive of a high grade precancerous lesion (AMBS 2004), or histologically confirmed high grade precancerous lesion (HSIL-CIN2 or HSIL-CIN3 as per LAST terminology). of the cervix is characterised histologically by mitotic figures in epithelial cells undergoing cell division, nuclear abnormalities including enlarged nuclei and irregular nuclear membranes, and little to no cytoplasmic differentiation in the middle third and upper third of the epithelium.

Invasive squamous cell carcinoma is categorised as:

  • SISCCASuperficially invasive squamous cell carcinoma (previously termed 'Micro-invasive carcinoma'): superficially invasive squamous cell carcinoma (previously termed microinvasive carcinoma)
  • SCCSquamous cell carcinoma: squamous cell carcinoma

See also Chapter 3. Terminology.

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See:

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References

  1. Darragh TM, Colgan TJ, Cox JT, Heller DS, Henry MR, Luff RD, et al. The Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions: background and consensus recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology. J Low Genit Tract Dis 2012 Jul;16(3):205-42 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/22820980.
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