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Histologic and Immunohistochemical Characteristics of Neoplastic and Nonneoplastic Subgroups of Atypical Squamous Lesions of the Uterine Cervix

Chisa Aoyama MD, Paul Liu PhD, MD, Nora Ostrzega MD, Christine H. Holschneider MD
DOI: http://dx.doi.org/10.1309/FB900YXTF7D2HE99 699-706 First published online: 1 May 2005


Atypical squamous lesion (ASL), a histologic diagnosis of unclear significance in the uterine cervix, can be divided into neoplastic and nonneoplastic groups. We aimed to determine the morphologic characteristics of these 2 groups. Histologic and immunohistochemical features were evaluated on the original biopsy specimen from 37 ASL cases, and the results were compared between neoplastic (19 cases) and nonneoplastic (18 cases) groups, which were determined based on the follow-up histopathologic findings.

Mitosis, vertical nuclear growth pattern, no perinuclear halo, indistinct cytoplasmic border, primitive cells in the upper third of the squamous layer, p16+ cells in the upper two thirds of the squamous layer, and Ki-67+ cells in the upper two thirds of the squamous layer were significant indicators for neoplastic ASLs. Of the 19 neoplastic ASLs, 16 (84%) had 5 or more of these 7 indicators. The majority (16/18 [89%]) of the nonneoplastic ASLs had 2 or fewer indicators. Determination of the histologic and immunohistochemical characteristics is useful for distinguishing neoplastic and nonneoplastic ASLs.

Key Words:
  • Atypical squamous lesions
  • Ki-67
  • p16
  • High-grade squamous intraepithelial lesion
  • HSIL
  • Uterine cervix