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Should I Go For A Leep Procedure As Per My Pap Test Report?

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. Aarti Abraham (34 minutes later)

Brief Answer:
AS BELOW

Detailed Answer:
Hello
Thanks for writing to us with your health concern.
Can you please upload both the reports - the Pap and the Colpo + Biopsy ?
That way I would have a better idea.
Also, any other risk factors - age, number of sexual factors, onset of sexual activity, weight, family history of any cancers etc ?
Looking forward to hearing from you.
Take care.

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

Follow up: Dr. Aarti Abraham (10 minutes later)

ok let me get it.some info first..have 3 kids.I am 32 have had 2 partners in the last 8years.and one I am stable with now.had a leep 2 years ago.no family cervical cancers.16 and 18 tested negative.hpv hr dna detected and also hpv detected it said.ill get results now

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Home » Health Record » Lab Results» YH Gyn Cytology Report - 04/23/2014
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YH Gyn Cytology Report - 04/23/2014
WellSpan Pathology Report
Patient:     OROZCO, XXXXXXX J
MRN:     YH-0000
Collected:     04/15/2014 17:30
Report Date:     04/23/2014 14:16

Clinical Information
Submitted As: Thin prep vial with preservative
LMP Date: 4/14/2014
GYN History/Treatment/Symptoms: +HPV
EC0000

Testing Requested
Pap, Diagnostic, with HPV

Specimen Source
Cervix/endocervix

Specimen Adequacy
Satisfactory for evaluation. Transformation zone component present.

Diagnosis
EPITHELIAL CELL ABNORMALITIES - SQUAMOUS
High Grade Squamous Intraepithelial Lesion (encompassing CIS; CIN 2 and CIN 3).

Note
In the absence of technical problems, liquid-based specimens are routinely analyzed with the automated assistance of the ThinPrep Imager System followed by microscopic evaluation by a Cytotechnologist and/or Pathologist.
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Tophis is the pap

urgical 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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Sorry I sent same one twice..THIS IS THE BIOPSY ONE

He couldnt really give me an answer on how results are different.he just wanted to do a leep again right away...I dont like that idea if I dont need it.so ya...hpv positive.but 16 and 18 are negative.I have cervicitis and had my period when pap was done.my last two apps after leep were clean.nothing abnormal.

Follow up: Dr. Aarti Abraham (5 minutes later)

Sorry I sent same one twice..this is biopsy result

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Home » Health Record » Lab Results» Surgical Pathology Report - 05/05/2014
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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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Sorry I sent same one twice..THIS IS THE BIOPSY ONE

Answered by Dr. Aarti Abraham (42 minutes later)

Brief Answer:
AS BELOW

Detailed Answer:
Can you please specify the chronology.
WHen was the first LEEP?
Why was that done ?

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

Follow up: Dr. Aarti Abraham (9 minutes later)

First leep was 2 years ago.I hadn't had a pap in eight years and then it was indeed hgsil.this pap report u are looking at was the third one after the leep.the first two post leep were fine.last good one was lastjuly.thw first two reports you see up there are the same.thwy are of my pap from this april.the third report is from the biopsy done after the pap in april.the biopsy was done two weeks after the pap

Answered by Dr. Aarti Abraham (2 hours later)

Brief Answer:
AS BELOW

Detailed Answer:
As your first two follow up smears were fine, this one does raise a red flag.
It points towards a high grade lesion - basically a change in the cervical cells which is dangerous and a precursor for cancer, not necessarily leading to it, but a high risk factor for it.
Now, a biopsy is taken from random areas - it is quite possible for the biopsy to miss the particular areas where this change is occurring the maximum.
A LEEP would remove a considerable portion of the cervical cells as opposed to a biopsy which only takes a representative sample.
It is possible that the biopsy shows cervicitis, which is inflammation.
Basically, inflammation, metaplasia ( change in normal cells ) and dysplasia ( high grade lesions which are one step away from cancer ) are a progression in continuum.
IN view of the high grade lesion, and prior history, yes, a repeat LEEP is a better and safer option, if there is no other contraindication from your side, such as fertility.
All the best
PLease feel free to discuss further.

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

Follow up: Dr. Aarti Abraham (9 hours later)

yaaa I guess ill go.lol I rescheduled my leep for july.either way a leep is no big deal.thank you :-)

Answered by Dr. Aarti Abraham (1 hour later)

Brief Answer:
AS BELOW

Detailed Answer:
Yes, that is the way to move ahead !
A LEEP is really no big deal and the results would only reassure you.
I understand your anxiety and meanwhile am glad you took the right step ahead.
Take care, and feel free to contact me anytime, using the link -
http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623

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