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New Case: LGSIL, years in the makingFrom: Joanne Bulley, MD (jbulley@cheshire.net)Thu Aug 31 21:27:58 2000
44yo G0, moves to my area and comes to me. She has a litany of interactions with docs she was not thrilled with and "interviews" me before she decides whether she will have me do her Pap. 9 years ago had repeated bouts of post coital bleeding and what we then called cervical erosion or eversion. Normal Pap, so cryo done and no more PCB. 8 years ago - LGSIL with HPV. Colpo and biopsy then cryo Since then the ONLY normal Pap was 1 year ago at her last docs. No Pap since. During that 8 years, she has numerous colpos, biopsies and 2 LEEP's. In 98 or 99 she had HPV typing - because all the paps and biopsies said koilocytosis and HPV - and was negative for all 9 (or 12?) types of HPV in the screen. So... I pass the screening test with her and we complete the rest of her history and physical. The SCJ is visible but the cervix is pretty nearly flush with the vaginal apex. Pap - LGSIL with some koilocytosis. Who wants to do what... with/for this patient?
-- Joanne Bulley, MD Keene, NH, USA
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