Lgsil Results And High
LGSIL results are not typically something to worry about immediately, but people who have an increased risk of developing cervical cancer for other reasons may need earlier or further follow-up.
Conditions considered to add to the higher risk include:
- People who are living with HIV
- People who have received a solid organ or stem cell transplant
- People who are immunosuppressed, such as those taking medication for a rheumatoid disorder like lupus or for inflammatory bowel syndrome
- People who were exposed to diethylstilbestrol in utero
Early testing and follow-up care may include annual Pap smears starting one year after initiation of sexual intercourse. Colposcopy may be needed even with mild LGSIL changes on a Pap smear, in keeping with guidelines for people who are considered high-risk.
Cervical Cancer Healthcare Provider Discussion Guide
Get our printable guide for your next healthcare provider’s appointment to help you ask the right questions.
Frequently Asked Questionsexpand All
- What is cervical cancer screening?
Cervical cancer screening is used to find abnormal changes in the cells of the cervix that could lead to cancer. Screening may include the Pap test, testing for a virus called human papillomavirus , or both.
- What causes abnormal cervical cancer screening test results?
The main cause of cervical cancer is infection with HPV. There are many types of HPV. Some types have been linked to cancer of the cervix, vulva, , , and . Some also can cause cancer of the head and neck. These types of HPV are known as high-risk types.
Most cases of cervical cancer are caused by just two high-risk types of HPVtype 16 and type 18. Cells that are infected with HPV appear different from normal cells under a microscope. Abnormal changes can be mild, or they can be more serious. The more serious changes can lead to cancer if not treated.
- How are HPV test results described?
HPV test results show whether you have a high-risk type of HPV infection. Results are negative or positive:
A negative HPV test means that you do not have an HPV type that is linked to cancer.
A positive HPV test means that you have an HPV infection. This does not mean that you have cancer now, but it may be a sign that cancer could develop later. You may need follow-up testing .
Endometrial samplingA sample of the endometrium is collected for study. Some women with an AGC result need to have this follow-up test.
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Squamous Intraepithelial Lesions Of Uterine Cervix And Bethesda System
How to cite this article: Alrajjal A, Pansare V, Choudhury MS, Khan MY, Shidham VB. Squamous intraepithelial lesions of Uterine Cervix and Bethesda System. CytoJournal 2021 18:16.
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Can Men Have Hpv
But HPV virus in men can cause health problems, too. HPV infection can increase a mans risk of getting genital cancers, although these cancers are not common. HPV can also cause genital warts in men, just as in women. More than half of men who are sexually active in the U.S. will have HPV at some time in their life.
Herpes Simplex Virus Cytopathic Effects
Herpes simplex viral cytopathic effects. Chromatin margination to the nuclear membrane periphery with ground-glass appearance and inclusions in some cases. Nuclei mold into each other. All three classic nuclear features 3 Ms multinucleation, molding, margination may not be seen in early herpes infection.
- Classic 3 Ms: Multinucleation, Margination , and Molding
- Multinucleation with multiple nuclei should not be mistaken for multinucleation seen in LSIL
- Chromatin margination to the nuclear membrane periphery giving rise to central ground glass appearance is a characteristic feature of HSV effect
- Early HSV infection may not show all three classic features and may manifest only as nuclear hyperchromasia mimicking with some nuclear features of ASC, LSIL, or HSIL.
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Understanding Your Biopsy Results
Your biopsy may not find any abnormal cells. This is known as a normal result. Depending on your age, you’ll be invited for a cervical screening appointment in 3 or 5 years if you get a normal result.
Or your biopsy may find abnormal cervical cells. This is known as an abnormal result. Its not cancer, but there is a risk the cells could turn into cancer in the future if not treated.
Doctors use the following terms for abnormal cervical cells:
- cervical intra-epithelial neoplasia
- cervical glandular intra-epithelial neoplasia
|You will be offered treatment to remove cells
In rare cases, a colposcopy and biopsy will find cervical cancer. If this happens, you’ll be referred to a team of specialists to discuss treatment.
So What Happens After The Lsil Finding
Any abnormal Pap result requires immediate follow up with yourgynecologist. If youre between ages 21 and 24, your doctor will likelyrecommend a repeat Pap smear in one year to see if your immune systemeffectively fought off the HPV.
If youre over age 25 and test positive for HPV, well likely use a minor procedure to get a magnified view of your cervix, says Dr. AlHilli. If needed, we may collect a small sample of cervical cells for biopsy.
These tests help your doctor see if there are any precancerous cells. Then your doctor determines if you need additional treatments, such as a procedure to remove the abnormal tissue.
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What Are My Options For Follow
If your pap smear is mildly abnormal you can choose to repeat the Pap smear in 6 months or have a colposcopy.
If the Pap smear is HSIL the recommendation is for you to have a colposcopy. A colposcope allows your healthcare provider to view the cells on your cervix more closely and possibly take samples of abnormal cells for further evaluation by a laboratory. This is called a biopsy.
You may also choose to have a test for HPV. This test will tell you if you have the high or low risk types of HPV. The HPV test is helpful if the results indicate that you have the low risk types of HPV because you will know that there is little chance that the cell changes found on your Pap smear will get worse. If the HPV test comes back with results that indicate the high risk types of HPV it is helpful because you may choose to get close follow-up.
Remember both high risk and low risk types of HPV can go away within 24 months.
8 ACOG Announces New Pap Smear and Cancer Screening Guidelines
On Friday, November 20, 2009, the American College of Obstetricians and Gynecologists announced that women should have their first cancer screening at age 21 and can be rescreened less frequently than previously recommended.
Approach For Cytomorphologic Interpretation Of Hsil
Under low-power view, two-dimensional sheets of cells or multiple three-dimensional hyperchromatic crowded groups seen as a syncytium can be identified. In general, CIN 2 cells may be seen as checkerboard pattern and CIN 3 cells as the syncytial aggregates . In liquid-based cytology preparations, HSIL cells tend to present as scattered single dysplastic cells, which if scant in number, may be easily missed .
Figure 9:: Figure 10:: Figure 11::
Under high-power view, one can easily identify significant nuclear atypia characteristic of HSIL. Careful examination of nuclear membrane and chromatin pattern would differentiate dysplastic cells from reactive cells, especially the smaller sized cells such as basal and parabasal cells seen in atrophic smears . In general, HSIL cells are smaller than LSIL, both in terms of cytoplasmic volume and the actual nuclear size with high N/C ratio. However, the nuclei display significant dysplastic features such as hyperchromasia, coarse but delicate chromatin, and nuclear membrane irregularities without nucleolar prominence. Longitudinal nuclear grooves and indentations are seen typically. These key nuclear features may not be necessarily displayed all together in the same HSIL case, rather, one or more of the characteristic features tend to predominate.
Figure 12:: Figure 13:: Figure 14:: Figure 15:: Figure 16::
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Atypical Squamous Cells : Includes Asc
ASC interpretation should be used to designate ASCs that fall short of LSIL and HSIL features due to quantitative or qualitative limitations.
The current terminology divides ASC into two distinct subcategories:
Although this category is created, it is expected to be used carefully and not as non-specific dustbin interpretation. This category should be reported with appropriate management recommendation under the comment section as indicated. The frequency of ASC interpretation among laboratories differs based on the patient population and the interpretation skill level of the cytopathology laboratory.
In general, the ASC category is the most frequent interpretation in abnormal category . ASC category should not exceed 5% based on expert consensus. However, for laboratories with higher risk population, ASC/SIL ratio of 3:1 can be used as a QA measure to monitor over and under interpretation. The currently available parameter related to ASC incidence in relation to HPV positivity is additional QA measure.
What Happens In A Colposcopy
Okay, lets do a deeper dive into this since its sometimes a necessary part of following up after an abnormal Pap smear result .
A colposcopy typically takes about 10 to 20 minutes, according to the Mayo Clinic. As we mentioned, during a colposcopy your doctor will use a magnifying tool to examine your cervix, along with the help of a bright light, the Mayo Clinic says. After inserting a speculum , the doctor will clear mucus from your cervix and with cotton so they can get a better look. They might apply a solution to your cervix for an even clearer picture of whats going on. The solution makes it easier to see abnormal cells.
Its one thing to know how a colposcopy will happen. Its another thing to know how it will feel. You already know the deal with speculums: They might be uncomfortable but shouldnt actually be painful. As for the colposcopy part, the solution might cause some burning or tingling, according to the Mayo Clinic. “Some people say its irritating, but it doesn’t typically hurt,” Dr. Nevadunsky says.
If your doctor notices any suspicious areas during this exam, they’ll take a small piece of tissue to biopsy, using a special tool to cut off a sample. This may be uncomfortable but wont necessarily be painful, according to the Mayo Clinic.
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How Is A Pap Smear Performed
Most women experience a small amount of cramping when their cervix is brushed, but this sensation should last only a minute or less. The cell samples will be placed in a glass bottle or on a glass slide and sent to the lab. A trained technician will examine the cells under a microscope to check if there are any abnormalities and report the findings to your doctor.
Your Feelings About Cell Changes Coming Back
You may feel a mix of emotions on hearing that cell changes have come back from relief that they have been found and can to be treated, worry about the next steps, or upset that you have to go through this again . There is no right or wrong way to feel, but it is important that you are able to manage those emotions and get the right support.
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My Pap Smear Came Back Abnormalshould I Be Worried
If you get a call from your doctors office about an abnormal pap smear, you might start to freak out. Dr. Kirtly Parker Jones says its a good idea to take a deep breath first. Many times, the doctor doesnt scrape enough cells and you need another smear. Dr. Jones explains the many reasons you could be called backincluding some comforting information and statistics about treatments.
Announcer: Covering all aspects of women’s health. This is The 7 Domains of Women’s Health with Dr. Kirtly Jones on The Scope.
Dr. Jones: So you just got a call from your doctor or probably your doctor’s nurse, who told you that your pap smear was slightly abnormal or was abnormal and you need to come back in. Well, should you hang it up and write your will or is it going to be okay?
What Happens After A Cervical Biopsy
If the biopsy results come back from the lab and show no precancerous cells, your doctor will typically just ask you to come back for a repeat Pap smear at some point sooner than usual, like within a year.
A biopsy can return a number of possible results that will require more immediate follow-up procedures, like a result showing the presence of precancerous or cancerous cells. In that kind of scenario, your doctor may recommend an excisional treatment, which is used to confirm the presence of precancerous or cancerous cells and how severe they are, ACOG explains.
There are two common ways doctors perform excisional treatment for this situation: a loop electrosurgical excision procedure and conization.
LEEP uses a thin wire loop that functions like a scalpel to cut away a thin layer of surface cells from the cervix. Like a colposcopy, it can take around 10 to 20 minutes, the Cleveland Clinic explains. First, your doctor will insert a speculum, then apply local anesthesia with a needle to numb your cervix. Once youre numbed, the doctor will use a thin wire loop to remove cells from your cervix. After that, your doctor might apply a paste to your cervix to help control post-LEEP bleeding.
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Why Do Cell Changes Come Back
After treatment for cell changes:
- about 9 in 10 people will not have cell changes again
- fewer than 2 in 10 people may have cell changes that come back.
Cell changes may come back if we have a virus called human papillomavirus . Its a common virus that most of us will get at some point in our lives. There are over 200 HPV types, including some that can cause cell changes in the cervix. We call these types high-risk HPV.
Usually, your immune system gets rid of HPV without it causing cell changes, but some people find HPV harder to clear. Sometimes, HPV can stay in the body and cause the cells of the cervix to change.
Abnormal Pap Test What Should You Do
contributed by Annette Schork, R.N., BSN, OCN, CBCN, Cancer AnswerLine
Your health care provider tells you that you have an abnormal Pap test. It is difficult not to panic when you hear this information. Maybe you’re worried and wondering what this means and how it will affect you. It’s important to keep in mind the majority of abnormal Pap tests do not mean you have cancer. The most common reason for an abnormal Pap test is a vaginal or cervical infection that causes changes in the cells of your cervix. Most of these changes can be followed closely until they return to normal.
Pap tests can detect precancerous and cancerous conditions by collecting cells from the surface of the cervix. The pathologist will look at the cervical cells under a microscope. Sometimes these cells appear abnormal, but they are not completely cancerous. These are called precancerous cells, which means they might turn into cancer if not found and treated early enough.
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Summary Of Cytomorphological Features Of Lsil Cells
Nuclear enlargement with intermediate/superficial cell-like cytoplasm with relatively low N/C ratio, as compared to intermediate cells
Nuclear hyperchromasia with occasional binucleation
Variably irregular nuclear contours with sharp angulations and indentations
May show increased keratinization seen as dense orangeophilia
Sharply demarcated perinuclear cytoplasmic clearing with irregular outline with focal angulation is characteristic of HPV cytopathic effect
LSIL cells with immature metaplastic cytoplasm may be difficult to distinguish from ASC-H or HSIL. This may be associated with eosinophilic dysplasia or from acanthotic component of condylomatous lesion.
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