Epithelial Dysplasia
Following are the features of epithelial dysplasia:
Architecture And Cytologic Criteria For Grading Epithelial
Dysplasia Given by WHO (2005)
Epithelial Dysplasia Architecture Criteria
- Irregular epithelial stratification
- Loss of polarity of basal cells
- Basal cell hyperplasia
- Dropshaped rete pegs
- Increased number of mitotic fiures
- Abnormally superfiial mitosis
- Dyskeratosis, i.e. premature keratinization in the cell
- Keratin pearls within rete ridges.
Cytologic Criteria
- Anisonucleosis: Abnormal variation in nuclear size
- Nuclear pleomorphism: Abnormal variation in nuclear shape
- Anisocytosis: Abnormal variation in cell size
- Cellular pleomorphism: Abnormal variation in cell shape
- Increased nuclear cytoplasmic ratio
- Increased nuclear size
- Atypical mitotic fiures
- Increase in the number and size of nucleoli
- Hyperchromatism.
Epithelial Dysplasia Grading Of Epithelial Dysplasia
- Histopathological interpretation of potentially malignant disorders shows presence of epithelial dysplasia.
- There are numerous prognostic molecular markers but the epithelial dysplasia is considered to be the strongest predictor of future malignant transformation in potentially malignant disorders.
- Grading of epithelial dysplasia is divided into three categories:
Mild: Cellular atypia and architectural disturbances limited to basal and parabasal layers.
Moderate: Cellular atypia and architectural disturbances limited from basal to midportion of spinous cell layer.
Severe: Cellular atypia and architectural disturbances from basal layer to a level above midpoint of epithelium.
Carcinoma in situ: Theoretical concept of carcinoma in situ is that malignant transformation has occurred but invasion is absent.
This is the most severe form of epithelial dysplasia and involves entire thickness of epithelium.
This is cytologically similar to squamous cell carcinoma but architecturally the epithelial basement membrane remains intact and no invasion in connective tissue has occurred.
Leave a Reply