High-grade squamous intraepithelial lesion (HSIL) of the cervix with bizarre cytological appearances (‘pleomorphic HSIL’): a review of 19 cases

Stewart, Colin J.R.

doi:10.1016/j.pathol.2017.05.002

Cited by 6 publications

(11 citation statements)

References 16 publications

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“…High-grade squamous intraepithelial lesions (HSIL) cytologically consist of moderate and severe dysplasia CIN2, CIN3 and carcinoma in situ [2]. HSIL cells are smaller * email: claudiamehedintu@yahoo.com, Phone: (+)4 0722312976 # Authors with equal contribution with the first author and less mature, cells may occur singly or clustered, and the nuclear-cytoplasmatic ratio is higher than in LSIL, nuclear hypercromasia and irregular nuclear membranes being as well common [1,7,8].…”

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confidence: 99%

Colposcopic, Histologic and Immunohistochemical Assessment in Cervical Intraepithelial Lesions

Berceanu¹,

Paitici²,

Berceanu³

et al. 2018

Rev. Chim.

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It is widely accepted that HPV infection precedes the occurrence of neoplastic disease in a varying time frame, and HPV testing can detect 30-100% more cervical precancers than conventional cytology and 20-50% more precancers than liquid-based cytology. Low-grade squamous intraepithelial lesions include the categories of mild dysplasia, respectively cervical intraepithelial neoplasia grade 1, and complementary, various descriptors indicating the presence of Human papilloma virus, such as koilocytotic atypia or condilomatous dysplasia. High-grade squamous intraepithelial lesions cytologically consist of moderate and severe dysplasia, respectively cervical intraepithelial neoplasia grade 2, 3 and carcinoma in situ. The purpose of our paper is to analyze the cytological and colposcopic characteristics in low-grade squamous intraepithelial lesions and high-grade squamous intraepithelial lesions cervical lesions and to accomplish histological and immunohistochemical correlations in these cervical intraepithelial lesions. Systematic three-step colposcopic evaluation using successively, normal saline with or without green filter, acetic acid and Lugol staining provides enhanced efficiency to the colposcopic examination and allows a more individualized and targeted surgical, medical or expectant management. Special microscopic techniques are very important in diagnosing and grading cervical intraepithelial neoplasia.

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confidence: 99%

Colposcopic, Histologic and Immunohistochemical Assessment in Cervical Intraepithelial Lesions

Berceanu¹,

Paitici²,

Berceanu³

et al. 2018

Rev. Chim.

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“…PHSILs have previously been described by Stewart as markedly enlarged atypical squamous cells observed in areas of HSILs [ 5 ]. Based on this histological description, we selected 31 cases of PHSIL.…”

Section: Discussionmentioning

confidence: 99%

“…PHSIL was defined as HSIL exhibiting striking nuclear atypia, including marked pleomorphism, hyperchromasia [ 5 ], and significant nuclear enlargement (more than four times larger than normal basal cells), which was easily identifiable at scanning magnification. All hematoxylin and eosin-stained slides were thoroughly examined by a board-certified pathologist specialized in gynecological oncology (H.-S.K.).…”

Section: Methodsmentioning

confidence: 99%

“…The characteristic histological features of HSILs are familiar to all surgical pathologists who examine cervical biopsies or hysterectomy specimens [ 5 ]. The pathological diagnosis of a HSIL is straightforward in the great majority of cases, although potential histological mimics such as atrophy, transitional metaplasia, radiation effects, and reactive changes occasionally present difficulties [ 5 ]. We have recently experienced several cases of HSIL that displayed striking focal or diffuse nuclear enlargement and pleomorphism, often accompanied by increased mitotic activity and frequent atypical mitoses.…”

Section: Introductionmentioning

confidence: 99%

“…Although these atypical nuclear features are very unusual, they are readily recognizable at scanning magnification. The nature and significance of these nuclear alterations in HSILs have previously been reported in only a single study [ 5 ], in which this rare variant of HSIL was referred to as a pleomorphic HSIL (PHSIL). In this study, we investigated the clinicopathological characteristics and immunostaining results of a single-institutional series of 31 cases of PHSIL.…”

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confidence: 99%

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Clinicopathological Characteristics of Pleomorphic High-Grade Squamous Intraepithelial Lesion of the Uterine Cervix: A Single-Institutional Series of 31 Cases

Kim

Choi

et al. 2020

Diagnostics

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We investigated the clinicopathological characteristics of 31 cases of pleomorphic high-grade squamous intraepithelial lesions (PHSIL) of the uterine cervix. We reviewed electronic medical records and all available slides to collect clinical and pathological information. PHSILs were histologically characterized by significant nuclear enlargement, marked pleomorphism, hyperchromasia, increased mitotic activity, and frequent atypical mitoses. In the majority of cases (24/31; 77.4%), this striking nuclear atypia involved both the surface epithelium and the endocervical glands. In the remaining seven cases, pleomorphic cells were observed in the surface epithelium only. PHSILs involving both the surface epithelium and glands showed higher mitotic counts and Ki-67 labelling indices than the surface-only PHSILs. Invasive squamous cell carcinoma was present in only one case (3.2%), and none developed recurrent disease. Our observations of striking nuclear atypia in cases of HSIL did not indicate increased aggressiveness. Further investigations are required for confirmation of our data in larger cohorts.

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Response to: High-grade squamous intraepithelial lesion (HSIL) of the cervix with bizarre cytological appearances (‘pleomorphic HSIL’)

Ondič

Alaghehbandan

2018

Pathology

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High-grade squamous intraepithelial lesion (HSIL) of the cervix with bizarre cytological appearances (‘pleomorphic HSIL’): a review of 19 cases

Cited by 6 publications

References 16 publications

Colposcopic, Histologic and Immunohistochemical Assessment in Cervical Intraepithelial Lesions

Colposcopic, Histologic and Immunohistochemical Assessment in Cervical Intraepithelial Lesions

Clinicopathological Characteristics of Pleomorphic High-Grade Squamous Intraepithelial Lesion of the Uterine Cervix: A Single-Institutional Series of 31 Cases

Response to: High-grade squamous intraepithelial lesion (HSIL) of the cervix with bizarre cytological appearances (‘pleomorphic HSIL’)

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