15a - Histology of dysplasia

Question 1

What are the cytological changes seen in dysplasia?

Answer 1

• variation in nuclear size
• variation in nuclear shape
• variation in cell size
• variation in cell shape
• altered nuclear-cytoplasmic ratio
• atypical mitosis figures
• increased number and size pf nucleoli
• clear hyperchromatism

Question 2

What are the architectural changes seen in dysplasia?

Answer 2

• irregular epithelial stratification
• loss of polarity of basal cells
• drop-shaped rete ridges
• increased and abnormal mitoses
• premature keratinisation in single cells
• abnormal keratinisation
• keratin pearls within rete ridges
• loss of epithelial cell cohesion or adhesion

Question 3

What histological changes are seen in low grade dysplasia?

Answer 3

• easily identifiable tumour originates from squamous epithelium
• architectural change into lower third
• cytological atypia
• considerable keratin production
• stratification
• well formed basal cell layer around tumour
• tumour islands are well defined and continuous with surface epithelium
• invasion pattern with intact rete ridges

Question 4

What histological changes are seen in high grade dysplasia?

Answer 4

• there is little resemblance to normal squamous epithelium
• architectural change in upper third
• considerable atypia
• invade in non-cohesive pattern with fine cords, small islands and single cells
• prominent mitotic figures

Question 5

What histological changes are seen in carcinoma-in-situ?

Answer 5

• cytologically malignant bunt invading through basement membrane
• abnormal architecture that is full thickness and has severe cytological atypia
• mitotic abnormalities frequent