Evaluation of Low-Grade Squamous Intraepithelial Lesions, Cannot Exclude High-Grade Squamous Intraepithelial Lesions on Cervical Smear.
- Author:
Sung Ran HONG
1
;
Bock Man KIM
;
Hye Sun KIM
;
Yi Kyeong CHUN
;
Hy Sook KIM
Author Information
1. Department of Pathology, Cheil General Hospital & Women's Healthcare Center, Kwandong University College of Medicine, Seoul, Korea. hysook.kim@cgh.co.kr
- Publication Type:Original Article
- Keywords:
Cervix uteri;
Cytology;
Vaginal Smears;
Cervical intraepithelial neoplasia
- MeSH:
Biopsy;
Cervical Intraepithelial Neoplasia;
Cervix Uteri;
Female;
Follow-Up Studies;
Vaginal Smears
- From:Korean Journal of Pathology
2010;44(5):528-535
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: We examined cervicovaginal smears that contained definite low-grade squamous intraepithelial lesion (LSIL) cells and rare atypical cells suggestive of high-grade SIL (HSIL) (ASC-H) or contained borderline dysplastic cells between LSIL and HSIL. Such lesions were classified as LSIL-H. This study aimed to investigate the cytologic and histologic characteristics of LSIL-H category and we evaluated the associated clinical risk. METHODS: The histologic outcomes of LSIL-H were compared with those of LSIL and ASC-H. Both the cytologic and histologic findings of LSIL-H that were confirmed as cervical intraepithelial neoplasia 2 (CIN2) or greater (CIN2+) were investigated. RESULTS: LSIL-H accounted for 0.09% of the Pap tests. On the follow-up histology, the most frequent outcome was CIN2, and the risk of CIN2+ was higher than that for ASC-H. In the cases of LSIL-H that was histologically confirmed as CIN2+, most of the atypical cells suggestive of HSIL were cytologically similar to those of CIN2, and the corresponding cervical tissues were characterized by small CIN2+ lesions in a large background of flat condyloma/CIN1. The LSIL-H cases not confirmed on initial colposcopically-directed biopsy required further follow-up. CONCLUSIONS: LSIL-H may be a valid diagnostic category with distinctive features that are different from LSIL or ASC-H. LSIL-H needs further follow-up for the proper management.
