SCARY CERVICAL BIOPSY RESULTS??!!

[Jaelyn's Mama]

I am 20 years old and have always kept up with getting an annual pap since I was 14 years old. I just had a baby in June, and my pap I had done in August came back abnormal. The doctor told me it was normal, then come to find out 5 months later, I am contacted and told it was abnormal, and I had to have another one done. I did, it too came back abnormal, and had a colpscopy and biopsy done in 2 different parts. I just got my results back a few days ago, she didnt really explain **** to me,except that I have HPV. (I am currently in Europe, my husband is in the airforce) She is the only GYN doctor here, and i tried to get a hold of her, but it is impossible! She did give me a copy of my results and a pamplet about a LEEP procedure. I have to go back to Florida to have the procedure done, because they do not do it here. The results left me dumbfounded, and find it very nerve racking to wait another 3 weeks (when I go home) to find out what this all means. The first part says: fragment of TRANSFORMATION ZONE MUCOSA WITH METAPLASTIC SQUAMOUS EPITHELIUM REPLACING ENDOCERVICAL GLANDS. MILD NUCLEAR ATYPIA is PRESENT, favor REACTIVE CHANGE over Dysplasia.  The next one states: Fragment of TRANSFORMATION ZONE MUCOSA with a TINY FOCUS of HIGH GRADE SIL (CIN 2-3) They also did a Endocervical Curettage, I have no idea what that is, but that says: Fragments of endocervical glands with histology within normal limits. A minute tissue fragment is present that appears to have a mild nuclear atypia. Its origin and significance is uncertain. What does this mean?! Do I have cancer?

[H. Hunter Handsfield, M.D.]

You don't have cancer, only a mild cervical abnormality, probably due entirely to HIV (that's what "reactive change" means), i.e. not even to a stage that would be considered pre-cancerous (that would be dysplasia).  If the abnormality had never been picked up by pap smear, it probably would clear up on its own without ever progressing to anything dangerous.

I'm not positive you need the LEEP procedure.  Some gynecolgists might just do another biopsy, or simply follow repeated pap smears, then go to LEEP only if the situation persists or progresses.  Definitely you should not spend the money and inconvenience to travel from Europe to Florida just for this purpose; you can safely wait until you're going home anyway.  (But standard disclaimer here:  if your own doctor says otherwise, you need to follow her advice over mine.  I'm not making a specific diagnosis or giving you formal medical advice.)

See numerous other threads in this forum and other web-based information for information about HPV itself, how it is transmitted, etc.

Don't lose sleep over this.  Good luck--  HHH, MD

[worriedinus]

I am not a doctor, but can relate with you..  it sounds like you have what is called high grade cervical dysplasia.
i was in the same situation 2 years ago, and very scared. I did have the LEEP procedure done and i have had normal pap smears ever since. I had high grade dysplasia, which is what is sounds like you have. I do not know that the medical terms that you have given, but some of them are familiar to me. My suggestions is to read up on it as i did. And the most important thing is to have the procedure done, and continue with your pap smears after. It is hard not to be scared when you are going through this, but if you take care of this, it is something you can control, (or possibly cure by some gyno's account) If you have any questions, you can ask me about my experience. I will be glad to share them with you. It maybe enlighting to talk to someone that has gone through this.

Dr... Please forgive me if i am not correct about what i think she has been told is going on. It just sounds so familiar to what i was told..

[Katherine364]

When you say "due entirely to HIV" I'm assuming you meant to say "due entirely to HPV."  Sorry for the correction....I just wouldn't want this woman to read your answer and freak out.

Katherine

[H. Hunter Handsfield, M.D.]

Yes, I meant HPV, not HIV.  Thanks to Katherine364 for catching my typo.

To worriedinus:  jaelyn's Mama doesn't have high grade dyplasia; the biopsy doesn't clearly show dysplasia at all, or at most very early/mild dysplasia (see her quote from the biopsy report, "favor reactive change over dysplasia".  Her disease is much less advanced than yours apparently was.

HHH, MD

[Jaelyn's Mama]

thank you worriedinus, its nice to hear that i am not the only one that has or had to deal with this

[H. Hunter Handsfield, M.D.]

This is the question you posted as a new question, which I deleted--because I want to discourage people from starting new message threads rather than adding to the preceding ones.  Every new post prevents someone else with a real new problem from getting on the board with his or her question.

Jaelyn's MMa:  FIRST I WANT TO SAY THANK YOU, YOU MADE ME FEEL BETTER, BUT I AM STILL HAVING A PROBLEM. YOU DIDNT MENTION WHAT THE SECOND BIOPSY SAMPLE MEANT. THE ONE THAT SAYS: FRAGMENTS OF TRANSFORMATION ZONE MUCOSA WITH A TINY FOCUS OF HIGH GRADE SIL (2-3). ALSO, ABOUT HPV, IS IT POSSIBLE THAT MY PREGNANCY BROUGHT OUT MY HPV? I REMEMBER HAVING A LOT OF SKIN TAGS AROUND MY VAGINA WHEN I WAS PREGNANT, AND NONE BEFORE AND NONE NOW. BUT THANK YOU AGAIN VERY MUCH!

Sorry, I misread your second report, with a focus of high grade SIL  ("SIL" means squamous intraepithelial neoplasia, equivalent to high grade dysplasia.  I'm not an expert in interpreting biopsies, and don't know how to interpret the qualification of a "tiny focus".  You should follow up with a knowledgeable gynecologist; in contrast to my first reply, you might need a LEEP.  There still probably is no need for immediate return to the US for that procedure--but I wouldn't wait indefinitely.  The average time for progression to more serious disease--i.e., to the first stage of actual cancer--is several years.  But once again, please follow your doctor's advice if it conflicts with mine.

Pregnancy is a state of relative immune deficiency; it is possible that it allowed your HPV infection to flourish.

Good luck-- HHH, MD

[ttcagain]

hey girl i just wanted you to know that in 2001 i had an abnormal pap and was scared to death because they said it could be cancer and that scared me i thought i wasnt going to be cable to have kids n e more so i never did anything about it (ps this was after my first child)  well i got preggers again in 2003 and still hadnt done anything about it after i had my son i figured id get it looked at and it was almost "high grade" (i think thats what its called) i had the biopsy and leep proceedure (which hurt like hell, not trying to scare you) and ever since iv had normall paps and am now 5 months preggers with my third child.
i have told every female i know that if they ever get an abnormal pap not to wait like i did and do whatever your doc says to do.
i do agree that you dont need to go back to florida right now and you could wawit the 3 weeks but get it taken care of right away when you get back.
the leep proceedure might hurt but if you dont want cancer or want to be able to have more kids PLEASE ge tit done for your benefit.
michelle

[Jaelyn's Mama]

Thank you for that, I was real worried that I wouldnt be able to have any more kids. Although I am not itchin to get pregnant anytime soon being my first baby isnt even a year old, but I do want more. It took this for me to realize it. I figured the leep procedure would hurt, hell the biopsy hurt pretty bad, I cant wait for the thing with the current going in my crotch, but hey, if it gets rid of the problem, lets go!! Thank You all for making me feel better!

[kgrajeda]

A related discussion, severe dysplasia was started.