1. What is this? Which organ are we in?

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    • Normal squamous epithelium of the cervix
    • Bottom image is of normal cervix on colposcopy
  2. What is this?

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    HSIL seen on colposcopy
  3. What is this?

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  4. What is this?

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  5. What is this?

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  6. Image Upload 14What is on the right? The left?
    • Right: HSIL
    • Left: Normal cervical tissue
  7. What disease is this? What organ are we in? What is the purple portion of this? What is the pink portion and what lies inside it? What is the lesion? What causes this lesion?

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    • 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
  8. What is this?

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    Invasive squamous cell carcinoma seen on colposcopy
  9. What is this?

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    Lymphatic invasion by invasive squamous cell carcinoma (cervix)
  10. What is this?

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    Invasive squamous cell carcinoma of cervix
  11. What is this?
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    Invasive squamous cell carcinoma of the cervix
  12. What is this? What features are unique to some of these types of lesions?

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    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
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