[Search-frames]

[Search-no frames]

[UCHC Home]

[©]

[Feed Back]

[About]

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 2/3 of thickness

Clinical Correlations: • Lesions may be asymptomatic or causing pruritus • Usually found on pelvic examination • May be treated with ablation

References: • Cotran RS, Kumar V, Robbins SL. Robbins Pathologic Basis of Disease. 5th edition. W.B. Saunders Philadelphia 1994. pp. 1041-1042.