To my opinion, it is much more than condyloma accumulatum.  It has the configuration of condyloma, like finger-like projections (figure 2 is cross-section of the fingers), high up blood vessels and koilocytes.  But mitoses are very frequent and the last figure shows a mitotic figure almost on the surface.  Nuclear atypia is also quite striking.  Not very sure, but figure 4 appears to have an atypical mitosis; we call it tripod mitosis or Mercede Benz, if you like car.  For this reason, i would report this as CIN 2.  I wouldn't call this CIN 3 because i see squamous differentiation and there is still some cytoplasm.

She needs a colposcopy and sampling of endocervical canal.

Remember condylomas usually don't progress to cancer and CIN 2 has some chance to progress to cancer. 

Thanks.

To my opinion, it is much more than condyloma accumulatum.  It has the configuration of condyloma, like finger-like projections (figure 2 is cross-section of the fingers), high up blood vessels and koilocytes.  But mitoses are very frequent and the last figure shows a mitotic figure almost on the surface.  Nuclear atypia is also quite striking.  Not very sure, but figure 4 appears to have an atypical mitosis; we call it tripod mitosis or Mercede Benz, if you like car.  For this reason, i would report this as CIN 2.  I wouldn't call this CIN 3 because i see squamous differentiation and there is still some cytoplasm.

She needs a colposcopy and sampling of endocervical canal.

Remember condylomas usually don't progress to cancer and CIN 2 has some chance to progress to cancer. 

Thanks.

试着翻译，不对请指正：

我认为这个不仅仅是尖锐湿疣。它有乳头状结构，象指状突起（图2是其横断面），富于血管及中空细胞。但是核分裂很多并且最后一图在表面亦可见核分裂相。核异型性也很显著。虽然不是很确定，但是图4可见异常核分裂相，我们叫它为“三脚架样核分裂”（不知翻译对否？），如果是喜欢车子的你也可以叫它“奔驰型核分裂”。由此，我倾向于报CIN2级，不报CIN3级是因为我看到一些鳞状上皮分化并依然可见一些细胞胞浆。（这句似乎有出入？意思可能为向鳞状上皮分化并且胞浆也较丰富吧？）

病人需要做宫腔镜和宫颈管取样（是指TCT或者活检吧）

请记住尖锐湿疣通常不会发展为癌而CIN2级有些时候会进展为癌。

谢谢！

尖锐湿疣

 细胞异型太明确，只报湿疣不放心。

考虑，湿疣伴异型可能，乳头状鳞癌不全除外。建议，多取材多观察，看看有无浸润；注意基底情况如何？还可查查HPV看看是不是高危型。

支持3楼楼主的意见