1
|
Kim H, Choi S, Do SI, Lee SH, Yoon N, Kim HS. Clinicopathological Characteristics of Pleomorphic High-Grade Squamous Intraepithelial Lesion of the Uterine Cervix: A Single-Institutional Series of 31 Cases. Diagnostics (Basel) 2020; 10:595. [PMID: 32824242 PMCID: PMC7459519 DOI: 10.3390/diagnostics10080595] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/13/2020] [Accepted: 08/13/2020] [Indexed: 11/16/2022] Open
Abstract
We investigated the clinicopathological characteristics of 31 cases of pleomorphic high-grade squamous intraepithelial lesions (PHSIL) of the uterine cervix. We reviewed electronic medical records and all available slides to collect clinical and pathological information. PHSILs were histologically characterized by significant nuclear enlargement, marked pleomorphism, hyperchromasia, increased mitotic activity, and frequent atypical mitoses. In the majority of cases (24/31; 77.4%), this striking nuclear atypia involved both the surface epithelium and the endocervical glands. In the remaining seven cases, pleomorphic cells were observed in the surface epithelium only. PHSILs involving both the surface epithelium and glands showed higher mitotic counts and Ki-67 labelling indices than the surface-only PHSILs. Invasive squamous cell carcinoma was present in only one case (3.2%), and none developed recurrent disease. Our observations of striking nuclear atypia in cases of HSIL did not indicate increased aggressiveness. Further investigations are required for confirmation of our data in larger cohorts.
Collapse
Affiliation(s)
- Hyunjin Kim
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (H.K.); (S.C.)
| | - Sangjoon Choi
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (H.K.); (S.C.)
| | - Sung-Im Do
- Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea;
| | - Sang Hwa Lee
- Pathology Center, Seegene Medical Foundation, Seoul 04805, Korea;
| | - Nara Yoon
- Department of Pathology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Korea
| | - Hyun-Soo Kim
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (H.K.); (S.C.)
| |
Collapse
|
2
|
Response to: High-grade squamous intraepithelial lesion (HSIL) of the cervix with bizarre cytological appearances ('pleomorphic HSIL'): author reply. Pathology 2018; 50:370. [PMID: 29506750 DOI: 10.1016/j.pathol.2017.09.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 09/29/2017] [Indexed: 11/24/2022]
|
3
|
Ondič O, Alaghehbandan R. Response to: High-grade squamous intraepithelial lesion (HSIL) of the cervix with bizarre cytological appearances ('pleomorphic HSIL'). Pathology 2018; 50:369-370. [PMID: 29490871 DOI: 10.1016/j.pathol.2017.09.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 09/29/2017] [Indexed: 10/17/2022]
Affiliation(s)
- Ondrej Ondič
- Charles University and Charles University Hospital Pilsen, Department of Pathology, Medical Faculty, Pilsen, Czech Republic; Bioptická laboratoř, s.r.o., Pilsen, Czech Republic.
| | - Reza Alaghehbandan
- Department of Pathology, University of British Columbia, Royal Columbian Hospital, Vancouver, BC, Canada
| |
Collapse
|
4
|
Ondič O, Ferko R, Kičinová J, Bouda J, Kinkorová-Luňáčková I, Kupcová L, Zůchová M, Chytra J, Waloschek T, Tůmová Bartošková M, Alaghehbandan R, Němcová J. Significance of bizarre cells in cervical screening liquid-based cytology: A prospective study of 15 cases. Cytopathology 2017; 29:58-62. [PMID: 29154448 DOI: 10.1111/cyt.12494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The aim of this study was to assess the significance of bizarre cells (cells of squamous origin with a superficial squamous cell-type cytoplasm and characterised by multinucleation that produces bizarre nuclear shapes) in liquid-based cytology (LBC) Papanicoaou (pap) smears with clinical and histological follow-up correlation. METHODS Fifteen patients, all with LBC samples containing bizarre cells, were identified in routine ThinPrep® LBC workload. HPV testing was performed in each case using residual LBC material. Cytological-histological correlations were reviewed. RESULTS All 15 LBC samples contained bizarre cells and tested positive for high-risk HPV types. Ten of the 15 cases were identified as atypical squamous cells - cannot exclude an HSIL (ASC-H) with secondary diagnosis of low-grade squamous intraepithelial lesion (LSIL), while five cases were identified as high-grade squamous intraepithelial lesion (HSIL), and a subsequent biopsy was recommended. Additionally, 13/15 cases underwent cone biopsy or hysterectomy within 1-11 months, of which 10 showed histologically confirmed HSIL end-points. LSIL was present in three cases. Bizarre cells were identified in the HSIL epithelium of five cone biopsies. CONCLUSIONS Identification of bizarre cells in LBC is straightforward and may facilitate diagnosis. The cytology of bizarre cells is associated with HSIL in cone biopsies. We recommend assigning LBC samples containing bizarre cells as ASC-H with secondary diagnosis of LSIL.
Collapse
Affiliation(s)
- O Ondič
- Charles University, Medical Faculty and Charles University Hospital Pilsen, Pilsen, Czech Republic.,Bioptická laboratoř, s.r.o., Pilsen, Czech Republic
| | - R Ferko
- Charles University, Medical Faculty and Charles University Hospital Pilsen, Pilsen, Czech Republic.,Bioptická laboratoř, s.r.o., Pilsen, Czech Republic
| | | | - J Bouda
- Charles University, Medical Faculty and Charles University Hospital Pilsen, Pilsen, Czech Republic
| | - I Kinkorová-Luňáčková
- Charles University, Medical Faculty and Charles University Hospital Pilsen, Pilsen, Czech Republic.,Bioptická laboratoř, s.r.o., Pilsen, Czech Republic
| | - L Kupcová
- Bioptická laboratoř, s.r.o., Pilsen, Czech Republic
| | - M Zůchová
- Charles University, Medical Faculty and Charles University Hospital Pilsen, Pilsen, Czech Republic.,Bioptická laboratoř, s.r.o., Pilsen, Czech Republic
| | - J Chytra
- Charles University, Medical Faculty and Charles University Hospital Pilsen, Pilsen, Czech Republic
| | - T Waloschek
- Bioptická laboratoř, s.r.o., Pilsen, Czech Republic
| | - M Tůmová Bartošková
- Charles University, Medical Faculty and Charles University Hospital Pilsen, Pilsen, Czech Republic.,Bioptická laboratoř, s.r.o., Pilsen, Czech Republic
| | - R Alaghehbandan
- Department of Pathology, University of British Columbia, Royal Columbian Hospital, Vancouver, BC, Canada
| | - J Němcová
- Charles University, Medical Faculty and Charles University Hospital Pilsen, Pilsen, Czech Republic.,Bioptická laboratoř, s.r.o., Pilsen, Czech Republic
| |
Collapse
|