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High-grade squamous intraepithelial lesion (HSIL) is a squamous cell abnormality associated with human papillomavirus (HPV). It encompasses the previously used terms cervical intraepithelial neoplasia grades 2 and 3 (CIN 2 and CIN 3), moderate and severe dysplasia, and carcinoma in situ. In 1988 the Bethesda System for Reporting Cervical Cytology (TBS) introduced the current terminology for HSIL, which has since been adopted for histology specimens by the Lower Anogenital Squamous Terminology Standardization Consensus Conference (LAST) and the World Health Organization (WHO) in 2012 and 2014, respectively. Though not all HSIL will progress to cancer, it is considered a precancerous lesion and therefore is usually treated aggressively. Though HSIL can involve various cutaneous and mucosal sites within the anogenital tract, this summary will focus on cervical HSIL.
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