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I. Introduction

FIGURE 4.18 Dyskeratosis in high-grade keratinizing dysplasia. Single cell intraepithelial keratinization (dyskeratosis) is visible as eosinophilic, round cells, with a pyknotic nucleus.

of abnormal to differentiated cellular components within the epithelium. The system advocated by Crissman recognizes a category of "keratinizing dysplasia" to designate a lesion showing superficial keratinization in association with highgrade cytological features in the remaining mucosa. In these authors' experience, such lesions have a high incidence of local relapse, a high progression rate into invasive cancer [14,20], and a high content of aneuploidy [21]. Thus, they are included in a high-grade dysplasia group (SIN-LIN 3) [16,17], These authors further stressed that abnormal differentiation was present in these lesions in the form of aberrant keratinization (dyskeratosis), represented by single cell keratinization and keratin pearls, occurring in the midst of the epithelium [16]. Underreporting of "keratinizing dysplasia"

FIGURE 4.19 Keratinizing dysplasia. Marked pleomorphism occurs in the basal layer, associated with maturation in the keratinized superficial layer.
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