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Cancer: Cervical & Ovarian Message Board


Cancer: Cervical & Ovarian Board Index


Hi. I was just wondering if anyone could answer a question for me?

When my gyn called to let me know my results, all she said was that the LEEP confirmed the diagnosis of HGSIL and it seems as if we got all the dysplasia. So I have a pap scheduled for Nov. 6. Last week, I went to get copies of my 2 paps, ecc, punch biopsy and LEEP biopsy from the last 3 months. And there is one term I don't understand, and can't really find an explanation on the internet. It said "squamous intraepithelial lesion, high grade(CIN II/ CINIII) with gland (cypt) involvement"

Does anyone kow what the "gland (crypt) involvement" means?

They took two sections of my cervix. One was 1.4x1.0x0.5cm and the other was 2.0x1.6x0.5cm, is that fairly normal sized sections?

Thanks for any replies!
The gland/crypt are the glandular cells that are found in the endocervical canal. My leep pathology showed intraglandular extension (which is probably interchangeable with "crypt involvement"). I asked the gyn about this and he said it was not unusual given the severity of the lesion. The squamous cells line the surface of the cervix, but with that you would invariably get some kind of involvement of the endocervical (gland) cells if the lesion was present in the squamocolumnar junction. If your lesion was away from the scj, then only squamous cells would show up.

It is confusing for sure. Be sure to ask your doctor about the gland/crypt involvement and get his/her perspective. The above is just the way it was explained to me, so please do not take it as the absolute truth. Always best to discuss with your doctor.

Did the pathology report say anything about clear margins?

My LEEP took a 1cm X 1cm X 1cm. It all depends on the size of the lesion.

Karen
Thanks for your post Karen-

The margins were clear. It says "lesional tisue is not seen on the inked fragment edges." And later it says "deep margins are inked blue." It doesn't give any measurements, though.

The earlier ECC was negative, it stated "scant fragment of benign endocervix". So this gland (crypt) involvement would conflict with the ECC result?

Jen
Hi Jen,

It is hard to say whether the earlier ECC is conflicting or not. The ECC is a blind procedure, so it could be that it *missed* the affected cells. I know it sounds unlikely, but if you go and read any studies regarding ECC you will see varying viewpoints about the accuracy of ECC's. Nonetheless, it is a good way to screen for invasive carcinoma in the canal. Your doc is probably the best person to ask about this, my knowledge is pretty basic when it comes to the glandular stuff.

Great news about the margins - that will go a long way to making you feel confident about the procedure and may make waiting the next few months a little easier.

Hope this helps a bit.

Karen





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