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| Intraepithelial Neoplasia (Dysplasia )(CIS) |
| Etiology • Majority associated with human papilloma virus infection • Minority arise in setting of squamous hyperplasia |
| Pathogenesis • HPV infection integrates into host cell genome • Integration may alter either p53 or retinoblastoma gene activity • Unknown in non-HPV associated patients., |
| Epidemiology • Historically disease of elderly women • Multicentric, HPV associated lesions now seen increasing in women under 40. • Immunosupression. |
| General Gross Description • white patches "leukoplakia" are common • red patches may also be seen |
| General Microscopic Description •loss of a single basal layer with crowding of the squamous cells, hyperchromasia of the nuclei, and failure to mature •mitotic figures seen above the basal cell layer •thickened epithelium which may contain koilocytes •mild (VIN1) when abnormal cells involve <1/3 of epithelial thickness; moderate (VIN2) when between 1/3 and 2/3 and severe (VIN3) when >2/3 of thickness |
| Clinical Correlation • Lesions may be asymptomatic or cause pruritus • Usually found on pelvic examination • May be treated with ablation |
| References • Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 1041-1042. |
| Intraepithelial Neoplasia (Dysplasia )(CIS) |
| Synopsis by: Melinda Sanders M.D. (T80100M80702)[266] |
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