Abnormal cytology & histology of cervix _ Histopathology

1. Abnormal cytology & histology of
cervix
DR PRAMOD TAJANE
DNB, DGO

2. MORPHOLOGICAL ABNORMALITIES OF
NUCLEUS
Disproportionate enlargement
Irregular outline
Abnormal no.,size or shape
Hyperchromatsia
Condesation of chromatin
Multinucleation

3. ABNORMALITIES OF CELLS

4. NORMAL CELLS ABNORMALCELLS

5. MILD DYSKARYOSIS
Superficial or intrmediate type sqamous cells
Angular borders,transulent cytoplasm
Nucleus occupies>half of toyal area of
cytoplasm
Binucleation
This corelates with CIN 1

7. CIN1
 CIN1 (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

8. MODERATE DYSKARYOSIS
Intermediate ,parabasal or superficial type
sqaomous cells
Disproportionate nuclear enlargement
Hyperchromatasia
Nucleus occupies ½ to 2/3 of cytoplasm
Correlate with CIN 2

10. CIN2
CIN 2 with koilocytosis: disorganized
architecture of the lower half of the
epithelium with cellular criteria of malignancy
and viral infection.

11. SEVERE DYSKARYOSIS
Basal type cells, different shape & size
Round,oval polygonal or elongated in shape (fiber
cells )
Tadpole cell –severe dyskaryotic cell with tail of
cytoplasm
In clumps or singly
Nucleus fills the cell or rim of cytolasm
Coarse chromatin
Correlate with CIN3

13. CIN 3
 CIN 3 superficial parakeratosis. Contrast
with the normal exocervical epithelium.

14. KOILOCTOSIS
Nuclear abnormalities seen with HPV infection
Central clearing( perinuclear hallo)
Hyperchromatasia, multinucleation

16. CARCINOMA IN SITU
Parabasal cells
Increased N/C ratio
Irregular or multiple nucleus
Granular chromatin scanty cytoplasm

17. INVASIVE CARCINOMA
Cells are single or grouped in clusters
Irregular nucleic, clumping of chromatin
Large tadpole cells

20. COMPARISON OF CLASSIFICTIONS
PAP CLASSIFICTION WHO 1962 RICHART BETHESDA1991
REVISED 2001
CLASS1 NORMAL
INFLAMMATORY
ASCUS
CLASS 2
MILD DYSPLASIA CIN 1 LGSIL
MODERATE
DYSPLASIA
CIN2 HGSIL
CLASS3 SEVERE DYSPLASIA CIN3 HGSIL
CLASS4 CARSINOMA IN
SITU
CIN3 HGSIL
CLASS5 INVASIVE INVASIVE CANCER INVASIVE CANCER