How many histological levels should be examined from tissue blocks originating in cone biopsy and large loop excision of the transformation zone specimens of cervix?
OBJECTIVE
To establish the value of examining additional histological levels in cone biopsy and large loop excision of the transformation zone (LLETZ) specimens of cervix.


METHODS
Three deeper levels were examined from 200 consecutive cone biopsy and LLETZ specimens reported by a single pathologist.


RESULTS
Examination of the first deeper level resulted in cervical intraepithelial neoplasia (CIN) being identified for the first time in five cases and in CIN1 being upgraded in five more. Invasive cancer was discovered in two cases that had shown high grade CIN initially.


CONCLUSIONS
Examination of a single further level appears to be sufficient in those patients in whom a specimen is compromised because epithelium including the squamocolumnar junction is missing, or if there is a discrepancy between the histological findings and the preceding colposcopic or cytological history. If invasive disease is suspected on the basis of the cytological, colposcopic, or histological features, one or preferably two further levels should be examined.
Heatley
M K
MK
Department of Pathology, The Royal Liverpool University Hospital, Fifth Floor, Duncan Building, Prescot Street, Liverpool L7 8XP, UK.
D001706:Biopsy; D002584:Cervix Uteri / Q000473:pathology*; D005260:Female; D006801:Humans; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D002578:Uterine Cervical Dysplasia / Q000473:pathology*