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A 31-year-old woman (gravida 0, para 0) was noted to have high-grade squamous intraepithelial lesion at routine two-yearly cervical smear. At colposcopy, three separate acetowhite areas were seen. The colposcopic impression was of low-grade squamous intraepithelial lesion and chronic inflammatory change. A Lletz biopsy of the cervix was performed. The patient had been on microgynon 50, which she had ceased before the last period. The last menstrual period was 3 weeks prior to the colposcopy. No significant gynaecological or medical history was noted.
The gross specimen consisted of an intact Lletz biopsy of cervix measuring 17×10 mm and resected to a depth of 15 mm. The tissue was transected and blocked in toto. Histologically, high-grade squamous intraepithelial lesion (CIN 2) and associated koilocytosis consistent with human papillomavirus was seen. Background changes of moderate chronic cervicitis and associated squamous metaplasia were present. An additional finding noted were three circumscribed foci of cribriform glandular structures lined by two cell layers approximately 2 mm deep to the …