ReproHistoFinal

• Normal squamous epithelium of the cervix
• Bottom image is of normal cervix on colposcopy

HSIL seen on colposcopy

HSIL

HSIL

HSIL

• Right: HSIL
• Left: Normal cervical tissue

• High Grade Intraepithelial Lesion (HSIL) or Cercial Intraepithelial Neoplasia III (CIN III): occurs in cervix
• Purple area: epithelial surface of cervix
• Pink area: endocervical stroma containing endocervical glands
• Note the lack of squamous cell maturation as they move from the basement membrane to the surface in the middle of the image
• Also note that the squamous epithelium may extend into the endocervical glands but that this is not invasion and does not alter the prognosis
• High power: note features of dysplasia, including loss of cell polarity, crowding of cells, numerous mitoses above basal layer, abnormal mitoses, decreased N/C ratio
• Caused by: High risk HPV types 16 & 18

Invasive squamous cell carcinoma seen on colposcopy

Lymphatic invasion by invasive squamous cell carcinoma (cervix)

Invasive squamous cell carcinoma of cervix

Invasive squamous cell carcinoma of the cervix

Invasive squamous cell carcinoma of the uterine cervix: note the large irregularly shaped tissue fragement that is deep purple and has spread extensively into the underlying tissue (including the endocervical glands and cervical stroma)Some tumors may show keratinization with keratin or squamous pearlsHigh power: notice that there is chronic inflammatory infiltrate around the projecting tongues of invading tumor that reflects an immune response by the woman to the tumor