Histopathology basics · USMLE Step 1

Which histological change is most consistent with early neoplastic transformation in an epithelial tissue biopsy?

  1. Well-organized architecture with uniform, bland nuclei
  2. Intact basement membrane and no cytologic atypia present
  3. Disordered architecture with pleomorphism and increased mitoses, no invasion
  4. Large amounts of extracellular mucin as the only change
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Correct answer: Disordered architecture with pleomorphism and increased mitoses, no invasion

High-grade dysplasia shows disordered tissue architecture and cytologic atypia with increased mitoses, representing a pre-invasive neoplastic transformation; invasion (malignancy) requires basement membrane breach.

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