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Abnormal PAP test with absence of transformation zone on colposcopy. - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Average Posted in: Vaginal and Uterus Health
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
User :   Hello. I'm 28 had an abnormal pap ASCUS and was repeated and showed LSIL and I was referred for a colposcopy. My OBGYN stated she was unable to view the transformation zone and that no abnormal white or glowing areas were noted so she suspected that the abnormal cells were coming from the endocervical canal. She performed a biopsy with endocervical curagge. She stated she was going to think positive and she will counsel me more once the results are back. How concerning is it that the transformation zone was not visible? Or that there were no abnormal areas noted? How concerned should I be about the endocervical biopsy or the fact that she thinks it lies inside and is difficult to visually diagnose or rule out anything? How concerned should I be? I have no history of stds and I gave birth to twins via c section 5 months ago. The ascus pap was during pregnancy and the lisil 2 months postpartum. I do have a history of abnormal paps that I was never told the significance and they were never followed up or repeated.
Doctor :   hi
Doctor :   Dr. XXXXXXXX here.
Doctor :   let me read what you have typed
Doctor :   the chances are that the cervical canal cells are affected as said by your gynecologist
Doctor :   i would suggest you to wait for the results to come
Doctor :   only then it can be said with surety where and what is the problem.
Doctor :   how many abnormal PAP tests have you had and over how many years?
Doctor :   if a PAP smear comes abnormal, it should be followed up atleast every 3-6 months depending on the severity
Doctor :   usually t is done once a year for women who are sexually active, if it is negative on 3 consecutive years, then it should done once in every 3 years.
Doctor :   have you followed what I have said?
User :   Could you please explain the significance of the transformation zone and what that typically indicates if it isn't viewable? I have not kept count I did not have a regular gynecologist and typically had some at the health dept and a few in drs offices. Only one dr did a repeat and I was told they were still abnormal but no one ever followed up until now.
Doctor :   ok. i will explain
Doctor :   the tranformation zone is the junction of the normal and the abnormal cells, t looks whitish, and shiny
Doctor :   and indicates that there is some changes going on in the normal morphology
Doctor :   it is usually seen distinctly
User :   So if it isn't viewable?
Doctor :   i your case the problem could be that the tranformaion zone is inside the cervical canal
Doctor :   and hence not seen distinctly
Doctor :   so curettage from the endocervical canal is done in such cases when PAP picks up abnormal ceels, but no transformation zone is seen.
Doctor :   *cells
User :   Is that an indicator of possible severe dysplasia or does the tj typically recede into the canal on some patients?
Doctor :   the results if the curettage will indicate what type of cells are present, and what is the severity of them
Doctor :   when are your results due to come?
User :   Another week
Doctor :   ok. as of now, we can only wait for your test results to come
Doctor :   to see where you stand, and depending on that treatment will be advised
User :   Is it a red flag if the tj isn't visible? Thank u for your time and patience
Doctor :   if the test comes positive for endocervical cells being abnormal, then procedure called LEEP might be done.
Doctor :   it is to diagnose and treat abnormal cervical cells
User :   Ok thank you
Doctor :wwwe://www.wwww
Doctor :   you can go through this link to know more about it
Doctor :   and discuss possibility of getting it done with your gynecologist
Doctor :   is there anything else I can help you with?
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