Sever Dyskaryosis but no findings during Colposcopy

Dear Doctor,
I recently had a smear test (UK) which came back with the following results:

- severe dyskaryosis
- endocervical cells absents.

I was referred for a Colposcopy during which no abnormal cells were found.
She nurse could not do a punch biospy as there were no abnormal cells.
Even if there were abnormal cells, she could not take a biospy as i am pregnant.

However, she said afterwards that the abnormal cells may be hidden in the cervix canal, but as my cervix was tiny ( i have not had children before) she could not see inside.

So instead she repeated the smear test, and said the result will come back in 4 weeks.

My questions are:

- What are the implication of having abnormal cells in the cervix canal? Is this more serious than having CIN2/3?

- From my understanding, endcocervical cells denote cells found in the cervix canal. If they were absent on my smear sampling, then does that rule out the severe dyskaryosis in the cervix canal?

- I was approx 2 weeks pregnant when the smear was taken. Does pregnancy distort smear readings, and if so, how?

I look forward to your repsonse.

[Elaine Brown, MD]

Hi!
Dyskarytosis is worriesome only because sometimes there are some cells hidden by the dyskarytotic cells.  It is like a thickening of the tissue and is sometimes found in conjunction with dysplasia.  

If you were my patient, I would do as your nurse did--a colposcopy but no biopsies.  Certainly I would NOT try to biopsy the endocervical canal in a pregnant patient.  A repeat pap however may be able to obtain some endocervical cells so that you can get a better, more reassuring reading.

Dyskarytosis itself is not pre-cancerous, and if you were my patient,  I would not be terribly worried.  After you delivery your baby, it will be much easier to evaluate your cervix, and the healing process that occurs afterwards often clears up abnormal cells too.

I would repeat a pap at six weeks postpartum and also colposcopy IF that pap showed any worriesome findings.

Good luck and congratulations on your pregnancy!

Dr B

[AnnDavis]

Hi Doctor,

In the UK we refer to high grade pre-cancerous cells as severe dyskaryosis (or CIN3 on biopsy).

My seamr results showed severe dyskaryosis or what you would know as dysplasia.

So does your answer change in light of this?

My original question was:
1) What are the implication of having abnormal cells in the cervix canal? Is this more serious than having CIN2/3

2) From my understanding, endcocervical cells denote cells found in the cervix canal. If they were absent on my smear sampling, then does that rule out the severe dyskaryosis in the cervix canal?

3) I was approx 2 weeks pregnant when the smear was taken. Does pregnancy distort smear readings, and if so, how?

Thanking you again in advance.