Pathology

PRENEOPLASTIC LESIONS

INTRODUCTION
It is now well established that precancerous lesions of the cervix and invasive carcinoma of the cervix are a continuum of one disease process. It is possible to prevent deaths resulting from cervical cancer by early diagnosis and management of precursor lesions. Early diagnosis of preneoplastic lesions was ushered in as early as the 1950s by the use of smear examination

INTRODUCTION
It is now well established that precancerous lesions of the cervix and invasive carcinoma of the cervix are a continuum of one disease process. It is possible to prevent deaths resulting from cervical cancer by early diagnosis and management of precursor lesions. Early diagnosis of preneoplastic lesions was ushered in as early as the 1950s by the use of smear examination introduced by Papanicolaou. Introduction of colposcopy, cryosurgery and laser surgery in the last two decades has brought phenomenal changes in clinical diagnosis and management providing greater options for conservative treatment and reducing patient morbidity.

List of Contributors

  • Nomenclature of Precancerous Squamous Lesions of Cervix
  • Nomenclature of Precancerous Glandular Lesions of Cervix
  • Natural History of Premalignant Lesions
  • Histopathology of Precancerous Lesions
  • Low Grade CIN/SIL (CIN 1)
  • High grade CIN/SIL (CIN 11,Ill)
  • Location and spread (crypt involvement)
  • DNA PLOIDY AND HPV DNA IN PRENEOPLASIA
  • EXFOLIATIVE CYTOLOGY
  • Specimen adequacy
  • Cytological classification
  • CYTOLOGY OF SQUAMOUS INTRAEPITHELlAL LESION (SIL)
  • Cytology of low-grade SIL/CIN/CIN I
  • High-grade, SIL,CIN/CIN 11,Ill
  • Atypical squamous cells of undetermined significance (ASCUS)
  • PATHOLOGY OF ATYPICAL ENDOCERVICAL HYPERPLASIA (AEH) AND ADENOCARCINOMA-IN-SITU (AIS
  • CYTOLOGY OF ATYPICAL GLANDULAR HYPERPLASIA AND AIS
  • Endocervical brush
  • Endocervical Curettage (ECC)
  • Endocervical Microglangular hyperplasia
  • COLPOSCOPY OF PRECANCEROUS LESIONS
  • Acetowhite epithelium
  • Grading of colposcopic findings
  • COLPOSCOPY OF CERVICAL INTRAEPITHELlAL NEOPLASIA
  • MICROCOLPOHYSTEROSCOPY
  • MANAGEMENT OF PRENEOPLASTIC LESIONS OF CERVIX
  • Treatment options for CIN
  • A Ablative procedures
  • Electrocoagulation-diathermy
  • B. Excisional methods
  • Loop Electrosurgical Excision Procedure (LEEP) or Large Loop Excision of TransformationZone (LLETZ)
  • NEW MODES OF THERAPY
  • Medical/Chemical treatment of CIN
  • Prophylaxis
  • REFERENCES
  • Images of Preneoplastic Lesions