Response to: High-grade squamous intraepithelial lesion (HSIL) of the cervix with bizarre cytological appearances ('pleomorphic HSIL')
Abstract
We read with great interest the article by Dr Stewart1 on a specific subtype of cervical high-grade squamous intraepithelial lesion (HSIL), containing large cells with multinucleation designated as 'pleomorpic HSIL'. We are pleased to see that this paper corroborates our concept of 'bizarre cell dysplasia', which was initially presented at the 2015 USCAP (United States and Canadian Academy of Pathology) meeting.2 We subsequently published full details of 'bizarre cell dysplasia' in uterine cervix in February 2017.3 Further, we have prospectively studied such lesions from liquid-based cytology (LBC) perspective by examining LBC slides containing such cytomorphological features with follow-up histology data.4 We believe that both 'bizarre cell dysplasia' and 'pleomorphic HISL' represent same subtype of HSIL with some minor differences in features accented.
To the best of our knowledge, there were also two other studies on a very similar lesion presented at the 2017 USCAP meeting in San Antonio CORRESPONDENCE 369 TX, USA.5,6 Considering the growing interest in this area, we would be grateful to learn Dr Stewart's opinion on similarities between 'bizarre cell dysplasia' and 'pleomorphic HSIL'. Overall, it is our hope that further research and increasing recognition of 'bizarre cell dysplasia' (or 'pleomorphic HSIL') phenomenon in both LBC and histology platforms will lead to improvement of patient care and management.