Cervical Dysplasia (cont.)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- What is cervical dysplasia?
- What causes cervical dysplasia?
- Are there symptoms of cervical dysplasia?
- How is cervical dysplasia diagnosed?
- How is cervical dysplasia classified?
- What are the treatments for cervical dysplasia?
- Carbon dioxide laser photoablation
- Cryocautery
- Loop electrosurgical excision procedure (LEEP)
- Cold knife cone biopsy (conization)
- Hysterectomy
- What is the prognosis (outlook) for cervical dysplasia?
- Can cervical dysplasia be prevented?
- Cervical Dysplasia At A Glance
- Find a local Obstetrician-Gynecologist in your town
How is cervical dysplasia classified?
Cytologic analysis (screening tests)
Pap smear analysis and reports are all based on a medical terminology system called The Bethesda System that was developed at the National Institutes of Health (NIH) in Bethesda, Maryland in 1988 and modified in 2001. The major categories for abnormal Pap smears reported in the Bethesda Systems are as follows:
- ASC-US: This abbreviation stands for atypical squamous cells of undetermined
significance. The word "squamous" describes the thin, flat cells that lie on the
surface of the cervix. One of two choices are added at the end of ASC: ASC-US,
which means undetermined significance, or ASC-H, which means cannot exclude HSIL (see below).
- LSIL: This abbreviation stands for low-grade squamous
intraepithelial lesion.
This means changes characteristic of mild dysplasia are observed in the cervical
cells.
- HSIL: This abbreviation stands for high-grade squamous intraepithelial lesion. And refers to the fact that cells with a severe degree of dysplasia are seen.
Histologic analysis (cervical biopsies)
When precancerous changes are seen in tissue biopsies of the cervix, the term cervical intraepithelial neoplasia (CIN) is used. "Intraepithelial" refers to the fact that the abnormal cells are present within the lining, or epithelial, tissue of the cervix. "Neoplasia" refers to the abnormal growth of cells.
CIN is classified according to the extent to which the abnormal, or dysplastic, cells are seen in the cervical lining tissue:
- CIN 1 refers to the presence of dysplasia confined to the basal third of the
cervical lining, or epithelium (formerly called mild dysplasia). This is
considered to be a low-grade lesion.
- CIN 2 is considered to be a high-grade lesion. It refers to dysplastic
cellular changes confined to the basal two-thirds of the lining tissue (formerly
called moderate dysplasia).
- CIN 3 is also a high grade lesion. It refers to precancerous changes in the cells encompassing greater than two-thirds of the cervical lining thickness, including full-thickness lesions that were formerly referred to as severe dysplasia and carcinoma in situ.
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