Gynaecological pathologyIntermediateAnnotated

Cervical squamous intraepithelial lesion

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Clinical history

33-year-old with high-risk HPV positive screening result.

Specimen

Colposcopic punch biopsy · Stain: H&E and p16

Microscopic description

Full-thickness loss of maturation with nuclear crowding, hyperchromasia and mitoses above the basal third. Block-positive p16.

Diagnostic question

How does p16 immunohistochemistry assist in classification?

Reveal differential diagnosis
  • Low-grade squamous intraepithelial lesion
  • Immature squamous metaplasia
  • Atrophy
Reveal final diagnosis

High-grade squamous intraepithelial lesion (CIN 2–3)

Learning points

  • Block-positive p16 supports high-grade lesion
  • Patchy p16 does not support HSIL
  • Correlate with HPV status and cytology

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All whole-slide images in this library are anonymised and used under appropriate licence. Cases are provided for education only and must not be used for clinical diagnosis.