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
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