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Running Head: CERVICAL NEOPLASIA
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CERVICAL NEOPLASIA

CERVICAL INTRAEPITHELIAL NEOPLASIA

Definition:
 Cervical intraepithelial neoplasia (CIN), formerly called dysplasia, means disordered
growth and development of the epithelial lining of the cervix.

General Considerations
 Lower genital tract squamous intraepithelial neoplasia is often multicentric (i.e.
affecting multiple anatomic sites which embryologically are derived from the same
anogenital epithelium): cervical intraepithelial neoplasia (CIN), vaginal intraepithelial
neoplasia (VAIN), vulvar intraepithelial neoplasia (VIN), and perianal intraepithelial
neoplasia (PAIN).
 Approximately 10% of women with CIN have concomitant preinvasive neoplasia of
the vulva, vagina, or anus.
 Conversely, 40-60% of patients with VIN or VAIN have synchronous or
metachronous CIN.

Classification
 There are various degrees of CIN.
 Mild dysplasia or CIN I is defined as disordered growth of the lower third of the
epithelial lining.
 Abnormal maturation of two-thirds of the lining is called moderate dysplasia or CIN
II.
 Severe dysplasia, CIN III, encompasses more than two-thirds of the epithelial
thickness with carcinoma in situ (CIS) representing full-thickness dysmaturity
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CERVICAL NEOPLASIA
 While histologically evaluated lesions are characterized using the CIN nomenclature,
cytologic smears are classified according to the Bethesda system

The Bethesda System 2001

1. Specimen Type
 Indicate conventional smear (Pap smear) vs liquid-based vs. other

2. Specimen Adequacy
 Satisfactory for evaluation (describe presence or absence of endocervical
transformation zone component and any other quality indicators, e.g. partially
obscuring blood, inflammation, etc)
 Unsatisfactory for evaluation . . . (specify reason)


Specimen rejected/not processed (specify reason)



Specimen processed and examined, but unsatisfactory for evaluation of epithelial
abnormality because of (specify reason)

3. General Categorization (optional)
 Negative for intraepithelial lesion or malignancy
 Epithelial cell abnormality
 Other

4. Automated Review
 If case examined by automated device, specify device and result

5. Ancillary Testing

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CERVICAL NEOPLASIA
 Provide a brief description of the test methods and report the result so that it is easily
understood by the clinician

6. Interpretation/Result

Negative for intraepithelial lesion or malignancy
 Observed organisms, such as Trichomonas, Candida, bacteria, and cellular changes
consistent with herpes simplex virus, are reported
 Reporting other non-neoplastic findings is optional (i.e. inflammation, atrophy)

Epithelial cell abnormalities

1. Squamous cell
a) Atypical squamous cells of undetermined significance (...