Intraepithelial Neoplasia of the Lower Genital Tract (Cervix, Vulva) : Etiology, Screening, Diagnostic Techniques, Management - 27/08/11
Doi : 10.1016/B978-0-323-02951-3.50031-5
KEY TERMS AND DEFINITIONS
Atypical Squamous Cells (ASC). : Bethesda System term used to indicate that abnormal squamous cells are present that do not fulfill all the criteria for a diagnosis of a squamous intraepithelial lesion. It is commonly abbreviated as ASC. Two subtypes are recognized: ASC of undetermined significance (ASC-US) and ASC, cannot exclude a higher grade lesion (ACS-H).
Atypical Glandular Cells (AGC). : A Bethesda System term used to indicate that there are abnormal glandular cells present that do not fulfill all the criteria for a diagnosis of an adenocarcinoma in situ or adenocarcinoma. The term can often be further qualified if the cells of origin can be identified.
The Bethesda System (TBS). : A system of terminology for the reporting of cervical cytology test results that is used by virtually all cytology laboratories in the United States as well as in many other countries. It was last revised in 2002.
Carcinoma In Situ. : An older term, now mostly abandoned, to represent full epithelial thickness neoplastic changes. It has been replaced by the term cervical intraepithelial neoplasia 3.
Cervical Intraepithelial Neoplasia (CIN). : A premalignant change in the cervical epithelium. The cells have altered nuclei that have at least some features of a neoplastic process. CIN is graded in three steps. CIN 1 is of little or no clinical consequence as it is usually a result of a transient human papillomavirus infection only. In the past, CIN 1 was referred to as mild dysplasia. If the cellular changes are more extensive and include one half to two thirds of the thickness of the epithelium, it is referred to as CIN 2. Full-thickness cellular changes are referred to as CIN 3. CIN 3 includes those changes previously referred to as severe dysplasia and carcinoma in situ.
Colposcope (Colposcopy). : A low-power, binocular microscope that is mounted on a stand. It is focused approximately 30 cm from the objective lens. It is used to view the uterine cervix after a speculum has been introduced into the vagina. It is the diagnostic method of choice for the evaluation of most Pap test abnormalities.
Conization. : Removal of the central cervix for the purpose of diagnosis or treatment of cervical neoplasia. It may be performed either with a scalpel (cold knife cone) or by a loop electroexcision procedure.
Cryocautery. : An office method for the destruction of areas of CIN. Although its success rate is similar to that of a loop electroexcision procedure, it is used less frequently than in the past. One limitation is that no tissue sample is obtained.
Dysplasia. : An outdated term for the changes now called CIN.
Endocervical Sampling. : This refers to obtaining a sample from the endocervix to determine whether CIN is present. The sample can be collected with an endocervical brush (cytology) or an endocervical curette (histology).
High-Grade Squamous Intraepithelial Lesion (HSIL). : This is a term used in TBS to report cellular changes that are consistent with a histologic report of CIN 2 or CIN 3. It is slowly replacing the CIN terminology for histology specimens.
Human Papillomavirus (HPV). : This is a group of more than 100 types of DNA-containing viruses known to infect humans. More than 15 types may be found in the genital area. Cervical cancer virtually always contains HPV DNA. The vast majority of all sexually active individuals are infected with the virus at some time. In most cases, the infection is self-limited. Recently, vaccines have been developed that prevent HPV infection with the more common HPV types.
Loop Electroexcision Procedure (LEEP). : This is the most commonly used procedure for the removal of areas of CIN. It is an office procedure in which a thin electric wire loop is used to excise squamous intraepithelial lesions.
Low-Grade Squamous Intraepithelial Lesion (LSIL). : This is a term used in TBS to report cellular changes that are consistent with a histologic report of CIN 1. In most cases, it indicates that an active HPV infection is present.
Metaplasia. : The process by which an area of glandular epithelium is replaced by squamous epithelium. It is a normal process and its presence on a biopsy specimen is considered normal.
Mosaic. : A colposcopic term used to describe a tissue pattern that is often associated with neoplasia.
Pap Test (Pap Smear). : The concept that cancer could be diagnosed by the examination of cells was conceived by Dr. Papanicolaou, and the test retains his name. Originally, a sample of cells was scraped from the uterine cervix, spread on a glass slide, and fixed in alcohol. Samples are now most often placed in a vial of transport medium, and the actual slide is prepared in the laboratory. The Pap test is the most effective cancer screening procedure ever developed. In countries where most adult women are screened regularly, the incidence of invasive cervical cancer is reduced by approximately 70%.
Punctation. : A colposcopic term used to describe a tissue pattern that is often associated with neoplasia.
Satisfactory Colposcopy. : A colposcopic examination in which the entire transformation zone can be seen. All other examinations are termed unsatisfactory.
Transformation Zone. : This is the area between the border of squamous epithelium and glandular epithelium in the central cervix. Almost all significant squamous neoplasia originates in this area.
Atypical Glandular Cells (AGC). : A Bethesda System term used to indicate that there are abnormal glandular cells present that do not fulfill all the criteria for a diagnosis of an adenocarcinoma in situ or adenocarcinoma. The term can often be further qualified if the cells of origin can be identified.
The Bethesda System (TBS). : A system of terminology for the reporting of cervical cytology test results that is used by virtually all cytology laboratories in the United States as well as in many other countries. It was last revised in 2002.
Carcinoma In Situ. : An older term, now mostly abandoned, to represent full epithelial thickness neoplastic changes. It has been replaced by the term cervical intraepithelial neoplasia 3.
Cervical Intraepithelial Neoplasia (CIN). : A premalignant change in the cervical epithelium. The cells have altered nuclei that have at least some features of a neoplastic process. CIN is graded in three steps. CIN 1 is of little or no clinical consequence as it is usually a result of a transient human papillomavirus infection only. In the past, CIN 1 was referred to as mild dysplasia. If the cellular changes are more extensive and include one half to two thirds of the thickness of the epithelium, it is referred to as CIN 2. Full-thickness cellular changes are referred to as CIN 3. CIN 3 includes those changes previously referred to as severe dysplasia and carcinoma in situ.
Colposcope (Colposcopy). : A low-power, binocular microscope that is mounted on a stand. It is focused approximately 30 cm from the objective lens. It is used to view the uterine cervix after a speculum has been introduced into the vagina. It is the diagnostic method of choice for the evaluation of most Pap test abnormalities.
Conization. : Removal of the central cervix for the purpose of diagnosis or treatment of cervical neoplasia. It may be performed either with a scalpel (cold knife cone) or by a loop electroexcision procedure.
Cryocautery. : An office method for the destruction of areas of CIN. Although its success rate is similar to that of a loop electroexcision procedure, it is used less frequently than in the past. One limitation is that no tissue sample is obtained.
Dysplasia. : An outdated term for the changes now called CIN.
Endocervical Sampling. : This refers to obtaining a sample from the endocervix to determine whether CIN is present. The sample can be collected with an endocervical brush (cytology) or an endocervical curette (histology).
High-Grade Squamous Intraepithelial Lesion (HSIL). : This is a term used in TBS to report cellular changes that are consistent with a histologic report of CIN 2 or CIN 3. It is slowly replacing the CIN terminology for histology specimens.
Human Papillomavirus (HPV). : This is a group of more than 100 types of DNA-containing viruses known to infect humans. More than 15 types may be found in the genital area. Cervical cancer virtually always contains HPV DNA. The vast majority of all sexually active individuals are infected with the virus at some time. In most cases, the infection is self-limited. Recently, vaccines have been developed that prevent HPV infection with the more common HPV types.
Loop Electroexcision Procedure (LEEP). : This is the most commonly used procedure for the removal of areas of CIN. It is an office procedure in which a thin electric wire loop is used to excise squamous intraepithelial lesions.
Low-Grade Squamous Intraepithelial Lesion (LSIL). : This is a term used in TBS to report cellular changes that are consistent with a histologic report of CIN 1. In most cases, it indicates that an active HPV infection is present.
Metaplasia. : The process by which an area of glandular epithelium is replaced by squamous epithelium. It is a normal process and its presence on a biopsy specimen is considered normal.
Mosaic. : A colposcopic term used to describe a tissue pattern that is often associated with neoplasia.
Pap Test (Pap Smear). : The concept that cancer could be diagnosed by the examination of cells was conceived by Dr. Papanicolaou, and the test retains his name. Originally, a sample of cells was scraped from the uterine cervix, spread on a glass slide, and fixed in alcohol. Samples are now most often placed in a vial of transport medium, and the actual slide is prepared in the laboratory. The Pap test is the most effective cancer screening procedure ever developed. In countries where most adult women are screened regularly, the incidence of invasive cervical cancer is reduced by approximately 70%.
Punctation. : A colposcopic term used to describe a tissue pattern that is often associated with neoplasia.
Satisfactory Colposcopy. : A colposcopic examination in which the entire transformation zone can be seen. All other examinations are termed unsatisfactory.
Transformation Zone. : This is the area between the border of squamous epithelium and glandular epithelium in the central cervix. Almost all significant squamous neoplasia originates in this area.
Plan
© 2007 Mosby, Inc. Tous droits réservés.© 1971 Charles C Thomas. Publié par Elsevier Masson SAS. Tous droits réservés.© 1972 University Park Press. Publié par Elsevier Masson SAS. Tous droits réservés.
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