学习了

 I suspect invasive SCC (cannot tell microinvasive from outright invasive SCC before you measure the width and depth of the invasive focus) and also suspect lymphovascular invasion.

The suspicious cell nests are quite atypical with very prominent nucleoli and keratinization, both are signs of invasion.  Some nests are breaking from the basement membrane.  Not very sure, but my memory is: once you see lymphovascular invasion, you cannot call it microinvasive SCC anymore no matter how small the size is.  The size criterion for microinvasion is mildly different, i think it is no more then 7 mm in length and 3 mm in depth.

You can do immunostain for D2-40 and CD31, CD34 to confirm the lymphovascular invasion, and basemement membrane stain to determine the microinvasion or invasion size.

I would challenge the Shanghai authority's diagnosis by doing those special stains.  Maybe they are right, but i need evidence.  Anybody can see it has HSIL involving glands.  With biopsy and LEEP, HSIL is not a acceptable diagnosis here, we have to say CIN 2 or CIN 3.  HSIL is for cytology.

 我们的病理诊断：高级别宫颈上皮内瘤变累及腺体，局灶微小浸润性癌。

上海权威妇科病理学家会诊结果：高级别宫颈上皮内瘤变累及腺体。

我觉得够浸润了

需再切进一步证实。连续切片看看。

 学浅学习心得：异常分化成熟的鳞状上皮与间质直接接触，就可能是浸润。

学浅法则：间质中上皮巢越小，则浸润的可能性越大。如果上皮巢仅为一两个细胞组成，那一定是浸润。