By Edward B Stelow MD, Stacey Mills
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Extra info for Biopsy Interpretation of the Upper Aerodigestive Tract and Ear
Cytologic atypia, generally mild and confined to the lower one-third of the epithelium. Moderate dysplasia Architectural disturbance in the lower two-thirds of the squamous epithelium with moderate but not severe cytologic atypia. Severe dysplasia Architectural disturbance extending into the upper one-third of the epithelium with severe cytologic atypia or severe cytologic atypia with any degree of architectural abnormality. Carcinoma in situ Full-thickness architectural disturbance with severe cytologic atypia.
Undoubtedly, there is a complete spectrum of histologic changes that can be seen between the normal squamous epithelium of the upper aerodigestive tract and squamous cell carcinoma. How many lines one wishes to draw through this continuum is subjective. 2 WHO Classification of Precursor Lesions of Squamous Cell Carcinoma WHO Classification Histology Hyperplasia Thickened epithelium due to increased cell numbers. Normal maturation with no cytologic atypia. Mild dysplasia Lack of cellular maturation within the lower onethird of the epithelium.
Epithelial precursor lesions. In: Barnes L, Eveson JW, Reichart P, Sidransky D, eds. World Health Organization Classification of Tumors. Pathology and Genetics of Head and Neck Tumours. Lyon: IARC Press; 2005:177-179. 21. Jo VY, O’Connor SM, Stoler MH, Stelow EB. Carcinoma in situ and p16 status of head and neck squamous cell carcinoma. Mod Pathol. 2010;23:274A-275A. 22. Crissman JD, Fu YS. Intraepithelial neoplasia of the larynx. A clinicopathologic study of six cases with DNA analysis. Arch Otolaryngol Head Neck Surg.