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WHO Classification of Tumours
Squamous intraepithelial neoplasia (dysplasia), high grade
Esophagus


Definition

Intraepithelial neoplasia is defined as non-invasive cytological or architectural alterations that may lead to the development of invasive carcinoma. The traditional term dysplasia refers to the presence of morphological features of neoplasia
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Bosman FT, Carneiro F, Hruban RH, Theise ND (Eds.)
WHO Classification of Tumours of the Digestive System.
4th Edition
International Agency for Research on Cancer: Lyon 2010



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The development of oesophageal squamous cell carcinoma (SCC) is a multistep process, progressing from normal squamous epithelium to intraepithelial neoplasia (dysplasia), and eventually to invasive carcinoma

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Bosman FT, Carneiro F, Hruban RH, Theise ND (Eds.)
WHO Classification of Tumours of the Digestive System.
4th Edition
International Agency for Research on Cancer: Lyon 2010



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High-grade intraepithelial neoplasia (HGIEN) is associated with a high risk of progression to invasive carcinoma. Histological features include cellular disorganization/ loss of polarity and downward growth of the epithelium. Cytological abnormalities include hyperchromasia, increased nucleus:cytoplasm ratio and mitotic activity. In HGIEN, the abnormalities involve the upper half, and cytological alterations are greater than those in low-grade intraepithelial neoplasia (LGIEN).
In the Far East, the terms “squamous cell carcinoma in situ” and “noninvasive carcinoma” are used for HGIEN in which the full thickness of the epithelium is involved

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Schlemper RJ, Dawsey SM, Itabashi M, Iwashita A, Kato Y, Koike M, Lewin KJ, Riddell RH, Shimoda T, Sipponen P, Stolte M, Watanabe H (2000)
Differences in diagnostic criteria for esophageal squamous cell carcinoma between Japanese and Western pathologists.
Cancer 88: 996-1006




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Schlemper RJ, Riddell RH, Kato Y, Borchard F, Cooper HS, Dawsey SM, Dixon MF, Fenoglio-Preiser CM, Fléjou JF, Geboes K, Hattori T, Hirota T, Itabashi M, Iwafuchi M, Iwashita A, Kim YI, Kirchner T, Klimpfinger M, Koike M, Lauwers GY, Lewin KJ, Oberhuber G, Offner F, Price AB, Rubio CA, Shimizu M, Shimoda T, Sipponen P, Solcia E, Stolte M, Watanabe H, Yamabe H (2000)
The Vienna classification of gastrointestinal epithelial neoplasia.
Gut 47: 251-5




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Shimizu M, Nagata K, Yamaguchi H, Kita H (2009)
Squamous intraepithelial neoplasia of the esophagus: past, present, and future.
J Gastroenterol 44: 103-12




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Takubo K, Aida J, Sawabe M, Kurosumi M, Arima M, Fujishiro M, Arai T (2007)
Early squamous cell carcinoma of the oesophagus: the Japanese viewpoint.
Histopathology 51: 733-42



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Commentary: Preneoplastic lesions of the digestive system