High grade intraepithelial lesion (HSIL/CIN3) of the uterine cervix.
Clinical story
43 years old female with abnormal cervical cytology indicating HSIL at screening test. She was referred to the outpatient clinic, where the diagnosis was confirmed by colposcopy with biopsy and cervical curettage. A conization was performed.
Comments
Two longitudinal sections from a cervical cone are presented. At the vaginal or distal end, a normal mature appearing non-keratinizing squamous epithelium is covering the surface, while a mucinous epithelium is found in the endocervical/proximal end. Towards the transformation zone, the squamous epithelium becomes increasingly disorganized and atypical, with mitoses throughout all layers. No maturation of the squamous epithelium is seen in these areas. Downgrowth of dysplastic epithelium into cervical glands may be seen.
Learning goals
To recognize the the pathological changes of the uterine cervix and understand the importance of the transformation zone in the development of many if these lesions.