个人认为是CINI-CINII

期待免疫组化结果

倾向于基底细胞增生

In my humble opinion，there is no CIN in this case based on morphology alone. If you pay little attention to the surface change, you will notice the presence of hyperkeratosis and parakeratosis which tends to be mistaken for "HPV infection" both cytologically and histopathologically. So this is a typical case in an old lady with most likely prolapse-related change. The so-called "hyperplastic change at the basal portion" is likely caused by prolase-related stimulation. The p16 immunostain in this case is simply some background staining and should be interpreted as negative. If she has HPV test, my bet is that she is likely HPV-negative. So I would render my diagnosis as follow:

- Benign squamous mucosa with prolapse-related change, negative for dysplasia.

 杨斌老师回复：

根据我的看法，该例单凭形态学看来没有CIN。如果稍微注意一下表面的改变，会注意到在细胞学及组织学容易被误认为是“HPV感染”的过度角化以及角化不全。因此这是一个典型的病例：极可能是伴宫颈脱垂改变的老年女性。所谓的“基底部异型增生”可能是由脱垂相关刺激所致。该例的p16染色只是背景染色，可解读为阴性。如果患者做了HPV检测，我打赌其结果为阴性。因此我提出我的诊断如下：良性鳞状上皮伴脱垂相关改变，无异型增生

支持基底细胞增生，无CIN。

学习中

 这样的片子每天都会看到，有的时候真的不知道该怎么判定。学习！