WOMENS-HEALTH Messages for March, 1999: Re: Perplexed over biopsy results

Re: Perplexed over biopsy results

From: Thomas (anonymous@obgyn.net)
Thu, 25 Mar 1999 15:10:24 -0600 (CST)

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Was interested to read your post. There is nothing overtly incorrect about what your doctor said or the report. The confusion lies is terminology and different terms used in different systems. A histological (i.e. from biopsy rather than Pap smear)diagnosis can be made using one of three systems.

ON HISTOLOGY (i.e. after LEEP or biopsy); 'CIN 1', 'Mild dysplasia' and 'LSIL' are almost synonymous terms. 'CIN 2' and 'moderate dysplasia' are synonymous terms. The term 'CIN 3' encompasses 'severe dysplasia' and 'carcinoma in situ'. The term 'HSIL' encompasses 'CIN 2' and 'CIN 3' CIN - Cervical intraepithelial neoplasia HSIL - High grade intraepithelial lesions

More confused? Well it gets worse. On PAP smear the terms Mild and Moderate dyskaryosis are synonymous with Mild and Moderate dysplasia but the term severe dyskaryosis encompasses severe dysplasia and carcinoma in situ.

The long and short of it is that you have a high grade squamous intraepithelial lesion. You do not have invasive cancer. HSIL is a condition thought to be associated with the wart virus. The area of your cervix where flat, hard cells of your vagina meet round mushy cells of the lining of your womb is prone to infection from the wart virus and can cause changes in the cells. These changes can go on to form cancer. It is normal to have less severe changes (such as mild dysplasia)next to more severe changes such as severe dysplasia or carcinoma in situ (CIS). CIS IS NOT CANCER. That is why most of us do not use the term but use CIN 3 or HSIL istead as it does not cause unnecessary worry as it has in your case. However, all the terminology is academic. The long and short of it is that as you have had regular PAP smears and this abnormality has been sorted out, you have avoided getting cancer in the future. Well done.

Depending on the exact nature of your specimen that your doctor will find out having reviewed the slides it is likely that you will require no further treatment. You will require more regular Pap smears and there is a 5% chance that you may require another LEEP in the future. However, if you continue to have your Pap smears and colposcopy it is very unlikely that you will get cancer.

-- Thomas Ind MB BS MD MRCOG St George Hospital Kogarah Sydney Australia

For every complex problem there is a simple solution...and it's wrong. (H L Mencken).

Next message: Marna: "Question about "Clomid Challenge Test""
Previous message: Thomas: "Re: post - Spotting"
In reply to: clp: "Perplexed over biopsy results"
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