title: Pathologic features of anogenital precancerous high-grade squamous intraepithelial lesion (squamous cell carcinoma in situ).
abstract: BACKGROUND
  Precancerous high-grade squamous intraepithelial lesion (HSIL), the current consensus terminology for anogenital squamous cell carcinoma in situ (SCCIS), often presents with distinctive histopathologic findings that may be a function of anatomic site or associated human papillomavirus infection.
  
  
  METHODS
  Fifty-six specimens of anogenital HSIL were compared with an equal number of specimens of SCCIS from non-anogenital sites in regard to the presence of parakeratosis, flag sign in the stratum corneum, compact stratum corneum, hypergranulosis, koilocytes, small blue cells, clonal populations of keratinocytes, pagetoid scatter of atypical keratinocytes, clear cell change, glassy red cytoplasm, pigmentation, nuclear/cytoplasmic(N/C) ratio >2/1, nuclear hyperchromasia, pleomorphic nuclei, mitotic figures, abnormal mitotic figures, dyskeratotic keratinocytes, involvement of skin appendages, acantholysis and amyloid deposition.
  
  
  RESULTS
  Hypergranulosis, koilocytes, small blue cells, pigmentation, nuclear hyperchromasia, dyskeratotic keratinocytes and amyloid deposition were more frequently noted in anogenital HSIL. Parakeratosis, clear cell change, pleomorphic nuclei, skin appendages involvement and acantholysis were strongly associated with non-anogenital location. There was no significant difference in the incidence of the remaining features.
  
  
  CONCLUSIONS
  The strongest predicators of an anogenital location included hypergranulosis, koilocytes, small blue cells and nuclear hyperchromasia. Pigmentation and amyloid deposition were also strongly associated with an anogenital location.
authors.affiliation: Department of Dermatology, Guangdong Provincial Dermatology Hospital, Guangzhou, China.|Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Ruzeng
authors.initials: R
authors.lastname: Xue
authors.affiliation: Medical University of South Carolina, Charleston, SC, USA.|Dermatology Department, Kasr Al Ainy University Hospital, Cairo University, Giza City, Egypt.
authors.forename: Amira
authors.initials: A
authors.lastname: Elbendary
authors.affiliation: Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Manuel
authors.identifier: http://orcid.org/0000-0002-2502-7256
authors.initials: M
authors.lastname: Valdebran
authors.affiliation: College of Osteopathic Medicine, Touro University Nevada, Henderson, NV, USA.
authors.forename: Soham
authors.initials: S
authors.lastname: Chaudhari
authors.affiliation: Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Dirk
authors.initials: D
authors.lastname: Elston
mesh_terms: D001005:Anus Neoplasms / Q000473:pathology*; D002278:Carcinoma in Situ / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D011230:Precancerous Conditions / Q000473:pathology*; D012189:Retrospective Studies; D014565:Urogenital Neoplasms / Q000473:pathology*
keywords: Bowen's disease; anogenital; high-grade squamous intraepithelial lesion; pathology