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Dysplasia is the earliest form of precancerous lesion which pathologists can recognize in a pap smear or in a biopsy. Dysplasia can be low grade or high grade. The risk of low-grade dysplasia transforming into high-grade dysplasia, and eventually cancer, is low. Treatment is usually straightforward.
The two tiers or classifications are low or high grade dysplasia. Low grade dysplasia means that the tissue maintains the glandular structure, cellular variance (pleomorphism) is mild or absent, nuclei maintain basal polarity and mitotic activity is not markedly increased.
A low-grade squamous intraepithelial lesion (LSIL or LGSIL) indicates possible cervical dysplasia. LSIL usually indicates mild dysplasia (CIN 1), more than likely caused by a human papillomavirus infection. It is usually diagnosed following a Pap smear. [citation needed]
High-grade squamous intraepithelial lesion Represents a mix of low- and high-grade lesions not easily differentiated by histology; HSIL+ encompasses HSIL, AGC, and cancer; CIN 2 (Grade II) Moderate dysplasia confined to the basal 2/3 of the epithelium; Represents a mix of low- and high-grade lesions not easily differentiated by histology
Mild dysplasia Moderate dysplasia Severe dysplasia / carcinoma in situ HPV-negative lesion with atypical keratinocytes in the basal cell layer WHO 2003 [3] Vulvar intraepithelial neoplasia (VIN) 1: VIN 2: VIN 3: VIN 3 WHO 2014 and ISSVD 2015 [3] Low-grade squamous intraepithelial lesion (LSIL) High-grade squamous intraepithelial lesion (HSIL)
Hematoxylin and eosin stains from different sections of a single diffuse intrinsic pontine glioma specimen, showing low-grade (top) and high-grade (bottom) areas.. In pathology, grading is a measure of the cell appearance in tumors and other neoplasms.
LEEP cone biopsy displaying normal cervical epithelium (far left) progressing to borderline koilocytosis, to LSIL, and to HSIL (far right). A squamous intraepithelial lesion (SIL) is an abnormal growth of epithelial cells on the surface of the cervix, commonly called squamous cells.
indefinite for dysplasia (IND) low-grade dysplasia (LGD) high-grade dysplasia (HGD) carcinoma; A 2016 study found that the rate of progression to esophageal adenocarcinoma in Barrett's esophagus patients with no dysplasia, low-grade dysplasia, and high-grade dysplasia are around 0.6%, 13.4%, and 25%, respectively. [48]