Cervical Squamous Intraepithelial Lesions

Abstract

Cervical squamous intraepithelial lesions [also known as cervical intraepithelial neoplasias (CINs), cervical dysplasias] impact a significant proportion of the population and are among the most commonly encountered diagnoses for the cytopathologist and surgical pathologist. Screening programs to detect and eradicate the subset of these lesions that are precancerous remain among the most impressive success stories in preventative medicine. Although many aspects of cervical neoplasia are familiar to all pathologists, this is a perpetually dynamic field due to changes in both technology and prevalence, leading to ongoing refinement of patient management. Recent decades have seen a rapid expansion in our understanding of cervical carcinogenesis leading to the development of new diagnostic biomarkers, novel testing assays, and effective vaccines. Screening strategies have also undergone renovation in response to these developments. This chapter reviews cervical squamous intraepithelial neoplasia from its earliest historical characterizations to its most up-to-date molecular underpinnings. It covers terminology, epidemiology, and screening techniques. Cytological and histological features are reviewed, as are morphological mimics. Finally, the molecular basis for disease is discussed with attention to potential immunohistochemical and molecular biomarkers.