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What Does My Pap Smear And Biopsy Report Indicate?

Posted on Mon, 7 Jul 2014

Question: Confused....had abnormal pap.positive for hpv..negative for 16 and 18.thwn had colpo and biopsy and all that read was benign fragments.however, it did read I have cervicitis.doc wants another leep.I am not sure I should do that or get another pap?

Answered by Dr. Shanti Vennam (1 hour later)

Brief Answer:
Please upload reports.

Detailed Answer:
Hello,

Thanks for writing to us.

I would like to know the indications for which you had the tests and also about your risk factors, gynecological history and any other relevant findings.

I will be able to comment further with appropriate information.

Hope you will get back with information. I will be happy to help.

regards,
Shanti.V.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shanti Vennam (14 minutes later)

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Surgical Pathology Report - 05/05/2014
WellSpan Pathology Report
Patient:     OROZCO, XXXXXXX J
MRN:     YH-0000
Collected:     05/01/2014 16:00
Report Date:     05/05/2014 12:23

Surgical Final Diagnosis
A. Cervix at 4 o'clock, biopsy:
- Acute and chronic endocervicitis with squamous metaplasia.

B. Cervix at 10 o'clock, biopsy:
- Acute and chronic endocervicitis.
- Fragments of benign squamous epithelium.

C. Cervix at 12 o'clock, biopsy:
- Fragments of benign endocervical glands.
- Fragments of benign squamous epithelium.

D. Endocervical curettage:
- Fragments of benign endocervical glands.

Surgical Clinical Information
Clinical History: High grade squamous intraepithelial lesion.
EC0000

Surgical Gross Description
A. Container labeled: Orozco, XXXXXXX 4 o'clock cervical biopsy.
Received in formalin are 2 fragments of soft white XXXXXXX tissue measuring <0.1 and 0.1 cm. The specimen is wrapped in lens paper and submitted in its entirety. (1 block)

B. Container labeled: Orozco, XXXXXXX 10 o'clock cervical biopsy.
Received in formalin are few fragments of soft white XXXXXXX tissue measuring in aggregate 0.2 x 0.1 x <0.1 cm. The specimen is wrapped in lens paper and submitted in its entirety. (1 block)

C. Container labeled: Orozco, XXXXXXX 12 o'clock cervical biopsy.
Received in formalin are a few fragments of soft XXXXXXX tissue measuring in aggregate 0.2 x 0.2 x 0.1 cm. The specimen is wrapped in lens paper and submitted in its entirety. (1 block)

D. Container labeled: Orozco, XXXXXXX endocervical curettage.
Received in formalin are multiple fragments of soft XXXXXXX tissue admixed with mucus, measuring in aggregate 0.3 x 0.3 x 0.1 cm. The specimen is wrapped in lens paper and submitted in its entirety. (1 block)

Surgical Microscopic Description
Unless specified as gross examination only, the final diagnosis is supported by microscopic evaluation.
12s
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THIS IS FROM THE BIOPSY AND COLPO

Answered by Dr. Shanti Vennam (34 minutes later)

Brief Answer:
Detailed below.

Detailed Answer:
Hi,

Thanks for writing back.

I have gone through your reports. The pap smear and also the biopsy report are correlating and they suggest evidence of metaplastic changes in addition to cervicitis. Cervicitis, when chronic, may lead to metaplastic changes and later on to dysplastic changes. Though, evidence of lesion is not obvious in biopsy, it can happen at times.

In the current scenario, I would suggest that you go on to take another LEEP procedure as that would be my preferred way of treatment for such a clinical picture--a positive HPV, abnormal pap smear with severe lesion and nonspecific colposcopic finding.

Please discuss with your gynecologist for further support. You may defer treatment if you are anxious to conceive or if you wish to wait until another pap smear report.

Hope I have answered your query. Please contact if you need more help. I will be ready to help.

regards,
Shanti.V.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Shanti Vennam (34 minutes later)

Ty:-) had my leep appointment today and skipped it.I chickened out :-( so u believe the pap over the biopsy? Wouldn't a biopsy be more accurate?

Answered by Dr. Shanti Vennam (13 minutes later)

Brief Answer:
Both are equallygood.

Detailed Answer:
Hello,

Thanks for writing again.

According to my opinion, a technically good pap smear is as good as a colposcopy-guided biopsy. In your case, the clinical history of a positive HPV along with HGSIL on pap calls for the need to more intense therapy. In case of LGSIL, one can wait with repeated pap smears as the lesions regress spontaneously.

Hope I have answered all your queries. Please feel free to contact if you need any more help. I will be available to help.

Yes, in your case, LEEP would be the best option. Observation of white cells in colposcopy does not indicate any specific finding as such, it can be the acetowhite lesion seen with dysplasias or even in normal regions sometimes. A biopsy taken from the area would have been of much help.

If, in case, your doctor orders another pap smear and if it turns out to be normal, you can wait for another six months; else, go for further treatment immediately.

Hope I have answered your query. Please contact if you need any more information. I will be available to help.

Wish you good health.

well I rescheduled the leep.I wish he would give me another pap though.but you agree also that a leep to be best right? im just discouraged because the results are so different.he did see some white cells on the colpo.could that vibe caused from the cervicitis alone? and if I get another pap how long do you think I should wait?

regards,
Shanti.V.

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar