PRE-C

ANCEROUS LESIO

NS

OF TH

E CERVIX

NH

SC

SP

10

CL

I VE

HO

LG

AT

E

CIN

Nuclear changes

Epithelial maturation

Mitotic activity

Grading

HPV associated changes

IHC p16, MIB1

BENIGN MIMICS OF CIN

Immature squamous metaplasia

Basal cell hyperplasia

Low oestrogen states & atrophy

Transitional cell metaplasia

Repair

CGIN

High & Low Grade

Usually HPV related

Microscopic features

IHC p16, MIB1, CEA, BCL2

Distribution

VARIANTS OF CGIN

Intestinal

Endometrioid (avoid term)

Tubal

SMILE

Usually with CIN/CGIN

Manage as CGIN

Surface & crypt involvement

Mucin droplets in all layers

IHC p16, MIB1, p63(variable)

BENIGN MIMICS OF CGIN

TEM

Inflammatory-associated changes

AUDIT AND QUALITY ASSURANCE

Laboratory

Pathologists

Audit

MDTMs

Histology reporting

CONCLUSION

1. Refine reporting standards (IHC)

2. Refine reports (proformas)

3. Engage in IQA/EQA

4. Start SMILE(ing)