General pathology
Distinguish reversible adaptation, inflammation, dysplasia and malignancy. Histopathology must be interpreted with the clinical site and appearance.
Understand
Metaplasia, dysplasia and invasive malignancy are distinct processes. Inflammation may be acute or chronic; necrosis, repair and granuloma formation are patterns with multiple potential causes.
Assess
Describe the lesion precisely and use the pathology report in context. Sampling site, depth and clinical suspicion affect how much weight a negative or non-specific biopsy can carry.
Apply
Match the next step to clinicopathological agreement. A discordant benign biopsy in a clinically suspicious lesion warrants discussion or further sampling rather than simple reassurance.
Key distinctions
Dysplasia describes abnormal epithelial maturation and architecture, while invasion involves malignant cells breaching the basement membrane. Inflammation and healing may create reactive atypia. The report's wording, sample depth and margin orientation matter: “no dysplasia identified” in a superficial fragment is a narrower claim than “the lesion is benign”.
Think through a case
A suspicious tongue lesion returns a report of ulceration only from a superficial sample. The result does not adequately explain a fixed mass, so the clinicopathological mismatch needs action.
The distinction to remember
Do not confuse dysplasia with invasion, or a small negative sample with exclusion of cancer elsewhere in the lesion.
Test your recall
Does dysplasia itself prove invasive carcinoma?
Show answer
No; invasion beyond the basement membrane is a separate finding.