Abnormal cytology & histology of cervix

Abnormal cytology & histology of cervixDR PRAMOD TAJANEDNB, DGO

MORPHOLOGICAL ABNORMALITIES OF NUCLEUS Disproportionate enlargementIrregular outlineAbnormal no.,size or shapeHyperchromatsiaCondesation of chromatinMultinucleation

ABNORMALITIES OF CELLS

NORMAL CELLS ABNORMALCELLS

MILD DYSKARYOSIS

Superficial or intrmediate type sqamous cellsAngular borders,transulent cytoplasmNucleus occupies>half of toyal area of cytoplasmBinucleation This corelates with CIN 1

CIN1CIN1 (flat condyloma): an abnormal mitotic figure (yellow circle), numerous binucleated cells (green circle), superficial parakeratosis (red arrow). Disturbed structural organization of the epithelium in the lower third

MODERATE DYSKARYOSIS

Intermediate ,parabasal or superficial type sqaomous cellsDisproportionate nuclear enlargementHyperchromatasiaNucleus occupies to 2/3 of cytoplasmCorrelate with CIN 2

CIN2CIN 2 with koilocytosis: disorganized architecture of the lower half of the epithelium with cellular criteria of malignancy and viral infection.

SEVERE DYSKARYOSIS

Basal type cells, different shape & sizeRound,oval polygonal or elongated in shape (fiber cells ) Tadpole cell severe dyskaryotic cell with tail of cytoplasmIn clumps or singlyNucleus fills the cell or rim of cytolasmCoarse chromatinCorrelate with CIN3

CIN 3CIN 3 superficial parakeratosis. Contrast with the normal exocervical epithelium.

KOILOCTOSISNuclear abnormalities seen with HPV infectionCentral clearing( perinuclear hallo)Hyperchromatasia, multinucleation

CARCINOMA IN SITUParabasal cellsIncreased N/C ratioIrregular or multiple nucleusGranular chromatin scanty cytoplasm

INVASIVE CARCINOMACells are single or grouped in clustersIrregular nucleic, clumping of chromatinLarge tadpole cells

COMPARISON OF CLASSIFICTIONS

PAP CLASSIFICTIONWHO 1962RICHARTBETHESDA1991REVISED 2001CLASS1NORMAL INFLAMMATORYASCUS

CLASS 2MILD DYSPLASIACIN 1LGSILMODERATE DYSPLASIACIN2HGSILCLASS3SEVERE DYSPLASIACIN3HGSILCLASS4CARSINOMA IN SITUCIN3HGSILCLASS5INVASIVEINVASIVE CANCERINVASIVE CANCER