Cervix, High-grade squamous intraepithelial lesion, p16 stain

Cervix, High-grade squamous intraepithelial lesion, H&E stain
Details
Disease Category
Gender
Organ System/Discipline
Clinical History

65 year old female with benign cytology on pap smear, presents with multiple cervical polyps.

Case Discussion

High‐grade squamous intraepithelial lesions (HSILs) of the cervix are precursors of invasive cervical cancer (squamous cell carcinoma). The current HSIL classification corresponds to the older histological classification of CIN (cervical intraepithelial neoplasia) 2 or 3. In this case, HSIL is present incidentally within an endocervical polyp—an uncommon presentation.

Sections show an endocervical polyp with focal gland involvement by high grade squamous intraepithelial neoplasia (CIN 3). Involved areas show crowded squamous cells with enlarged, hyperchromatic and pleomorphic nuclei occupying the entire thickness of the epithelium. Mitoses are high and there is single-cell necrosis. Immunohistochemical staining shows strong, full thickness p16 reactivity and high Ki-67 proliferative index, further supporting the diagnosis of high grade cervical intraepithelial neoplasia.

This slide shows H&E stain. See related content for p16 stain.

Diagnosis
High-grade squamous intraepithelial lesion
Cervix, High-grade squamous intraepithelial lesion, p16 stain
Details
Disease Category
Gender
Organ System/Discipline
Clinical History

65 year old female with benign cytology on pap smear, presents with multiple cervical polyps.

Case Discussion

High‐grade squamous intraepithelial lesions (HSILs) of the cervix are precursors of invasive cervical cancer (squamous cell carcinoma). The current HSIL classification corresponds to the older histological classification of CIN (cervical intraepithelial neoplasia) 2 or 3. In this case, HSIL is present incidentally within an endocervical polyp—an uncommon presentation.

Sections show an endocervical polyp with focal gland involvement by high grade squamous intraepithelial neoplasia (CIN 3). Involved areas show crowded squamous cells with enlarged, hyperchromatic and pleomorphic nuclei occupying the entire thickness of the epithelium. Mitoses are high and there is single-cell necrosis. Immunohistochemical staining shows strong, full thickness p16 reactivity and high Ki-67 proliferative index, further supporting the diagnosis of high grade cervical intraepithelial neoplasia.

Diagnosis
High-grade squamous intraepithelial lesion