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Squamous Abnormalities

Low grade squamous intraepithelial lesion (LSIL)

Koilocytes

The appearance of low-grade squamous abnormalities in LBC is similar to that seen in CP, however in LBC the cells are more likely to be dispersed throughout the preparation rather than being in streaks or loose groups as in CP. Cellular detail, including nuclear enlargement, nuclear membrane irregularities and chromatin detail, may be clearer as a result of the rapid fixation in LBC collection.

ThinPrep® - LSIL

ThinPrep®  - LSIL

Koilocytes showing well-defined perinuclear clearing, bi-nucleation and mild nuclear abnormalities

ThinPrep® - LSIL

ThinPrep®  - LSIL

Squamous cells with slightly increased N:C ratio, nuclear membrane irregularity and chromatin clumping.

SurePath™ - LSIL

SurePath™ - LSIL

Squamous cells with slightly increased N:C ratio, nuclear membrane irregularity and mild nuclear hyperchromasia.

SurePath™ - LSIL

SurePath™ - LSIL

Koilocytes showing perinuclear clearing, binucleation, nuclear enlargement and nuclear membrane irregularities

High grade squamous intraepithelial lesion (HSIL)

As in CP, HSIL in LBC samples may present as single cells or as groups of cells. HSIL cells are generally smaller than those of LSIL. The N/C ratio is markedly increased, nuclear membranes are irregular and there is variable hyperchromasia with fine to coarsely granular chromatin, chromatin clumping and granularity. Nucleoli are inconspicuous or absent. Nuclear polarity within groups is irregular. Single cells may be dispersed in LBC preparations rather than in loose arrangements as in CP. Intact cell groups are preserved in LBC preparations

SurePath™ - HSIL

SurePath™ - HSIL

Single cells with markedly increased N:C ratio and chromatin clumping.

SurePath™ - HSIL

SurePath™ - HSIL

Crowded sheet of hyperchromatic cells with loss of nuclear polarity within the group

SurePath™ - HSIL

SurePath™ - HSIL

Loose cluster of small cells with markedly increased N:C ratio and irregularly-shaped hyperchromatic nuclei.

ThinPrep® - HSIL

ThinPrep®  - HSIL

Crowded sheet of hyperchromatic cells with loss of nuclear polarity within the group

ThinPrep® - HSIL

ThinPrep®  - HSIL

Small, loosely cohesive sheet of high N:C ratio cells with irregular nuclear membranes, mild hyperchromasia and chromatin clumping

ThinPrep® - HSIL

ThinPrep®  - HSIL

Strip of cells showing irregular nuclear membranes, hyperchromasia and anisonucleosis

Squamous cell carcinoma (SCC)

Cellular features of SCC seen in CP are also seen in LBC and may be better preserved so that chromatin clearing, nuclear membrane irregularities and nucleoli may appear more prominent. Cell groups may have a greater depth of focus. Tumour diathesis and necrotic debris may be observed in LBC samples.

SurePath™ - SCC

SurePath™ - SCC

Spindled and irregular shaped malignant squamous cells. Nuclear membranes are irregular with notches and indentations

SurePath™ - SCC

SurePath™ - SCC

Malignant squamous cells dispersed singly and in a small loose cluster.. Nuclear membranes are markedly irregular and there is coarse chromatin clumping.

ThinPrep® - SCC

ThinPrep® - SCC

Malignant squamous cells showing keratinization and necrotic changes. Nuclei are hyperchromatic and markedly irregular in size and shape. Degenerate blood and necrotic debris are present.

ThinPrep® - SCC

ThinPrep®  - SCC

Malignant squamous cells showing keratinization and spindled forms. Nuclei are irregular and hyperchromatic and degenerate blood cells are present.