1. PRE-CANCEROUS LESIONS OF THE CERVIX
Clive Holgate
NHSCSP10

2. CIN
Nuclear changes Epithelial maturation Mitotic activity Grading HPV associated changes IHC p16, MIB1

3. Benign Mimics of CIN
Immature squamous metaplasia Basal cell hyperplasia Low oestrogen states & atrophy Transitional cell metaplasia Repair

4. CGIN
High & Low Grade Usually HPV related Microscopic features IHC p16, MIB1, CEA, BCL2 Distribution

5. Variants of CGIN
Intestinal Endometrioid (avoid term) Tubal

6. SMILE
Usually with CIN/CGIN Manage as CGIN Surface & crypt involvement Mucin droplets in all layers IHC p16, MIB1, p63(variable)

7. Benign Mimics of CGIN
TEM Inflammatory-associated changes

8. Audit and Quality Assurance
Laboratory Pathologists Audit MDTMs Histology reporting

9. conclusion Refine reporting standards (IHC) Refine reports (proformas)
Engage in IQA/EQA
Start SMILE(ing)