week 4 cbl Flashcards
what is Dyskaryosis
‘Dyskaryosis’ implies definitely abnormal nuclei and the most likely reason for their presence is significant cervical intraepithelial neoplasia or CIN
what is CIN
cervical intraepithelial neoplasia. Detecting CIN is the reason for cervical screening as it is the pre-malignant lesion which can be treated before it becomes a cancer. Colposcopy and biopsy is required to evaluate the situation further.
what is the acetowhite colour during a colposcopy
change of the cervical squamous epithelium exposed to 5% acetic acid helps the colposcopist to identify areas of altered squamous epithelium and to target biopsies appropriately.
what are koilocytes
a sign of viral infection in the epithelial cells of the squamous cells of the squamous cervical mucosa
what does HHV8 have a role in
Kaposi’s sarcoma - usually in immunocompromised people
what treatment would you give someone that has koilocytes present
loop excision of the transformation zone
LETZ
This treats the abnormal epithelium and allows full assessment of the lesion by histo, and perhaps confirms CIN ,
what has replaced pap smear
liquid based cytology
what do normal squamous cells in the cervix look like
have abundant cytoplasm.
small regular nuclei.
different colours in cytoplasm reflect differences in keratinisation
characteristics of a koilocyte
characterised by a clearing of the cytoplasm around the nucleus of the cell - reliable sign of HPV infection .
hollow cell
what alerts the cytologist oto the possible presence of CIN
enlarged nuclei with abnormally coarse looking chromatin.
what is present in severe dyskaryosis
dysckaryotic cells and inflammatory cells .
nucleus to cytoplasm ratio is very high
what epithelium exists in the cervix
non keratinising stratified squamous . as cells migrate and mature towards the epithelial surface they accumulate glycogen which gives them characterised basket weave appearance
what is a sign of HPV infection
bi nucleate or multinucleate cells. imbalance between zone of proliferation and zone of differentiation
what is a sign of CIN 3
more than 2/3 of the epithelium is not differentiating
HPV effects include
koilocytes
dyskeratosis
multinucleated cells
