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B: Deep portion of the tumor with bulbous nests. 41 Invasive squamous carcinoma, condylomatous or warty type. A: Superficial portion, resembling condyloma acuminatum. B: Deep portion displaying large irregular tumor nests infiltrating the stroma. BASALOID SQUAMOUS CARCINOMA Basaloid squamous carcinoma is an underrecognized type of squamous carcinoma composed of large islands of mitotically active epithelial cells with hyperchromatic nuclei and peripheral palisading (Fig. 43). Keratinization can be present or absent.

60) (12). Important caveats in the interpretation of p16 results are as follows: (a) approximately one-third of the LSILs show “block-type” positivity (14), (b) the concept of “continuous block staining” requires an “adequate” sample of properly oriented tissue that must correlate with the area of morphologic concern (12), and (c) a rare case of HSIL will fail to show the “block-type positivity” most likely due to preanalytic factors (15). In our practice, we systematically pair the use of p16 with Ki-67 to address items (a) and (c), although as per the CAP-ASCCP LAST project the use of either Ki-67 or ProExC immunostains as an adjunct of p16 or when dealing with equivocal p16 is optional (12).

In some cases, a single layer of flattened umbrella-like cells can be detected (Fig. 13, e-Figs. 22). This metaplastic process may involve the exocervix, transformation zone, surface epithelium of the endocervix, or endocervical glands (13,14). Immunohistochemically, transitional cell metaplasia like normal urothelium expresses cytokeratins 13, 17, and 18; however, it is differentiated from the latter by the lack of expression of cytokeratin 20 and asymmetric unit membrane. This finding has prompted the use of the term immature transitional metaplasia by some authors (15).

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