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Stratified mucin‐producing intraepithelial lesion (SMILE): report of a case series with associated pathological findings
Author(s) -
Boyle David P,
McCluggage W Glenn
Publication year - 2015
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.12498
Subject(s) - medicine , biopsy , cervical intraepithelial neoplasia , lesion , dysplasia , pathological , mucin , pathology , adenocarcinoma , squamous intraepithelial lesion , cervical cancer , cancer
Aims Stratified mucin‐producing intraepithelial lesion ( SMILE ) is an uncommon premalignant cervical lesion showing morphological overlap with cervical intraepithelial neoplasia ( CIN ) and adenocarcinoma in situ ( AIS )/cervical glandular intraepithelial neoplasia. Given the limited literature on SMILE , we aimed to document its frequency and assess the associated pathology in a large series of cases. Methods and results Over a 6‐year period, we documented all cases of SMILE and the associated findings. SMILE was diagnosed in 69 specimens from 60 patients (50 loop excisions and 19 punch biopsy specimens), constituting 0.6% of cervical specimens. Overall, SMILE coexisted with high‐grade CIN in 93% of cases, AIS in 42%, and a carcinoma in 10%. When SMILE was diagnosed on a cervical punch biopsy, there was high‐grade CIN in the follow‐up loop in most cases. SMILE was consistently diffusely p16‐positive and IMP 3‐negative. Conclusions Given the morphological overlap and significant association with high‐grade CIN and AIS , we believe that SMILE is best regarded as a form of high‐grade reserve cell dysplasia, probably arising from reserve or stem cells with the capacity for multidirectional differentiation. We recommend that management of SMILE should be as for AIS .