HSIL is an abnormal growth of cells on the cervix found in a Pap smear, often linked to cervical cancer. LSIL indicates a small amount of abnormal cells, while HSIL indicates a large number of very abnormal cells covering much of the cervix. A doctor further examines HSIL by performing a colposcopy and biopsy. Follow-up is important as 20% of women with HSIL develop cancer in the future.
A high-grade squamous intraepithelial lesion, also called HSIL or HGSIL, is an abnormal growth of cells on the cervix. These cells are found in a Pap smear. The presence of HSIL is often linked to cervical cancer. Diagnosis usually indicates the need for further tests to assess the potential risk of cancer.
A Pap smear is part of a gynecological pelvic exam in which the doctor scrapes a small amount of tissue from the surface of the cervix. The cells are examined under a microscope in a laboratory, where a technician observes the size and shape of the cells. A diagnosis of low-grade squamous intraepithelial lesion, or LSIL, indicates that there is a small amount of abnormal cells and that not much of the cervix is affected. A high-grade squamous intraepithelial lesion indicates a large number of very abnormal cells covering much of the cervix.
An LSIL diagnosis may require another Pap smear in the near future to check for further cellular changes. Often an LSIL result can be a false positive caused by menstruation, an infection, or other foreign material on the cervix such as male ejaculate or lavage fluid. A diagnosis of HSIL usually requires further evaluation right away, as these are more likely to turn into cancer.
Usually, a doctor further examines a high-grade squamous intraepithelial lesion by performing a colposcopy. This procedure is similar to a pelvic exam, but uses an instrument similar to a small microscope that magnifies cells up to ten times their normal size. The extent of the abnormalities is evaluated, and the doctor also looks for changes in the cervical capillaries, which aren’t checked for in a Pap smear.
During cervical colposcopy, your doctor might also remove a tissue sample in a procedure called a biopsy. A cervical biopsy is usually uncomfortable, but not painful enough to require local or general anesthetics. The tissue sample is examined more closely for precancerous changes. In many cases, precancerous cells can be removed by freezing or cutting.
For most women, an abnormal Pap result is extremely upsetting. However, the diagnosis of a high-grade squamous intraepithelial lesion turns out to be cancer in less than two percent of cases. However, it is important to follow up on the diagnosis because 20% of women with HSIL develop cancer in the future. Aside from the colposcopy and biopsy, more frequent Pap smears are usually ordered to monitor for changes.
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