Cytology Quik-Pics: #1-Low grade squamous intraepithelial lesion (LSIL)

Low grade squamous intraepithelial lesion (LSIL): 

Cytology Quik-Pics: #1-LSIL

LSIL: Koilocytes-"koilocytotic atypia"

Sample Type: Liquid-based preparation: SurePath™

TBS Category: Epithelial Cell Abnormality

Interpretation: Low grade squamous intraepithelial lesion (LSIL)

Encompasses: HPV/mild dysplasia/CIN 1

Cytologic Criteria:

  1. koilocytes-hallmark of HPV cytopathic effect, perinuclear cytoplasmic halo; single cells or sheets of dysplastic cells, with or without koilocytotic atypia. Dense peripheral rim of cytoplasm borders optically clear, perinuclear halo.
  2. nuclear enlargement 4-6x the size of a normal intermediate cell nucleus
  3. nuclear hyperchromasia
  4. irregular nuclear membranes
  5. frequent binucleation or multinucleation
  6. finely granular, evenly distributed chromatin; infrequent nucleoli
  7. occasionally, the nuclei are degenerated and pyknotic, with “raisinoid” changes
Comments: The cytologic criteria are essentially the same for liquid-based cytology (LBC) samples and conventional smears. There may be some cases, perhaps more noticeable on SurePath™ LBC where the nuclear chromatin is normochromatic, or even hypochromatic.

Cytology Quik-Pics: #1 Quiz

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About Jana Sullinger

GYN Pathologist and Cytopathologist. Special interest in quality assessment and use of online social media in sharing educational information about cytology and quality.

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