同意

 Agree with CIN 3 with glandular involvement.  It is not low grade intraepithelial lesion (LSIL, CIN 1, mild dysplasia) because the dysplastic cells involve the entire thickness of the epithelium.  CIN 1 involves only the lower portion of the epithelium and usually shows koilocytes on top, not always.

It is really difficult to talk about how to grade dysplasia by words.  We need pictures and real cases.  Basically, you have to decide it is dysplasia first. Like this case, the differential considerations are between reactive changes, atypical immature metaplasia and high grade dysplasia.  Low grade is not even in the differential.  Once you decided it is dysplasia, you grade according to how high the dysplastic cells involve the epithelium: basal layer only(lower 1/3)or HPV changes, CIN1; to middle layer (2/3 of the thickness), CIN 2; the upper portion, CIN 3/squamous cells carcinoma insitu.  This is a very simple way to put it.  It is much more complicated in real life.