A cervical biopsy shows koilocytes, dysplastic cells confined to the lower 2/3 of the epithelium with preservation of the superficial zone, and no surface maturation. This is classified as:
- A High-grade squamous intraepithelial lesion (HSIL), equivalent to CIN 2–3, requiring treatment ✓
- B Low-grade squamous intraepithelial lesion (LSIL), equivalent to CIN 1, which usually regresses spontaneously
- C Invasive squamous cell carcinoma with keratin pearl formation
- D Adenocarcinoma in situ of the cervix
Correct answer: A. High-grade squamous intraepithelial lesion (HSIL), equivalent to CIN 2–3, requiring treatment
Explanation
The description — dysplasia occupying the lower 2/3 of the epithelium without surface maturation and with koilocytes — corresponds to CIN 2 (moderate dysplasia), classified as HSIL in the two-tier system. CIN 1/LSIL has dysplasia limited to the lower 1/3 with upper maturation and prominent koilocytes (often spontaneously regresses). CIN 3/HSIL extends through the full thickness. The 2-tier LSIL/HSIL WHO classification is now preferred, and HSIL requires treatment (LEEP or cone biopsy). Adenocarcinoma in situ involves glandular crypts.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.