TABLE 3.
Cytology and histology terminology for HPV-associated preinvasive squamous lesions of the lower anogenital tract, including vulva, vagina, cervix, penis, perianus, and anusa
| Dysplasia findings | Bethesda 2001 cytology terms | 2012 LAST histology terms |
|---|---|---|
| No epithelial abnormalities or benign cellular changes | Negative for intraepithelial lesions or malignancy (reactive cellular changes associated with inflammation or radiation and infectious organisms such as Trichomonas vaginalis, Candida species, or cellular changes associated with herpes simplex virus [HSV]may be noted in a comment) | Normal |
| Atypia, squamous epithelial cells; the squamous cells do not appear completely normal, but doctors are uncertain about what the cell changes mean; sometimes the changes are related to an HPV infection, but they can also be caused by other factors; ASC-H lesions may be at higher risk of being precancerous than ASC-US lesions | Atypical squamous cells (ASC): ASC-US (unspecified significance), ASC-H (cannot exclude HSIL) | Atypia |
| Koilocytosis, mild dysplasia, mild abnormalities caused by HPV infection | Low-grade squamous intraepithelial lesion (LSIL) | LSIL (formerly intraepithelial neoplasia [IN-1]) |
| Moderate dysplasia, severe dysplasia, carcinoma in situ, suspicious; more severe abnormalities that have a higher likelihood of progressing to cancer if left untreated | High-grade squamous intraepithelial lesion (HSIL) | HSIL/IN-2, IN-3 includes carcinoma in situ; when the diagnosis is IN-2 or when the differential diagnosis is between precancer (IN-2 or IN-3) and a mimic of precancer (atrophy, reparative epithelial changes, etc.), perform p16 immunostain to upgrade or downgrade; if negative, classify as LSIL and if positive, classify as HSIL |
| Invasive squamous cell carcinoma (cervical cancer) | Squamous cell carcinoma | Squamous cell carcinoma |
| Atypia, glandular epithelial cells | Atypical glandular cells (AGC); endocervical adenocarcinoma in situ AGC, favor neoplastic | NAb |
a
Adapted from reference 105 with permission from Elsevier.
b
NA, not applicable.