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RouxWoman 08-13-2007 09:29 PM

LADIES - Is there any other reason a pap
 
May be Dx as CIN/1-2-3 or Dysplasia, or actual cancer?

Could other problems/infections/skin problems/other vaginal issues cause this to happen?

Thanks!

piperpilot 08-14-2007 05:06 AM

Re: LADIES - Is there any other reason a pap
 
A PAP is a screen test. A cytologist exmines the cells collected in the media--either liquid or on a slide, then looks for abnormalities at the cellular level. Cytologist cannot see your vagina or cervix and therefore can only report that the cells that he looked at showed dysplastic abnormality (low grade or high grade)(which is not to be confused with low-risk or high risk OR mild or moderate or severe), or other un-determined abnomality (ASCUS-US). If the cytologist finds any dysplastic cells, he will grade the change as high-grade or low-grade. Both are dysplasia and require further follow-up, but it is somewhat subjective, that is, any two cytologists may interpret the same cellular change differently. Your Dr therefore cannot tell you conclusively how deep into the epithelium (cervical skin) these cell are found, or if they have invaded the stroma (tissue below the epithilium--which would indicate cervical cancer) until a biopsy is done and read by a pathologist. If you have had regular PAPS, and not previously had any dysplasia, the chances of these cells having penetrated into the stroma is VERY SLIM because the process usually takes many years to advance, if it does at all. To answer your question, no, the only way a PAP result could suggest CIN 1,2,3 or cancer would be the presence of dysplastic cells.

furtiva 08-14-2007 08:38 AM

Re: LADIES - Is there any other reason a pap
 
[QUOTE=RouxWoman;3154242]May be Dx as CIN/1-2-3 or Dysplasia, or actual cancer?

Could other problems/infections/skin problems/other vaginal issues cause this to happen?

Thanks![/QUOTE]

if your question is can the reason for the abnormal pap result be other than dysplasia/pre-cancer cells or cancer changes in your cervix, than the answer is YES.

There might be too many things that can cause and abnormal pap test (Ascus). When it comes to LSGIL or higher the presence of the cervix changed cells it's dictated therefore a colpo is required to identify the grade and scale of changes.

The main purpose of the PAP is look at drastical potential risky cervical changes, but it does detect other vaginal, ovarian, or endometrosis issues that might change the envirorment.

As far as the procedure detecting dysplasia, Piper got it all very well explained.

Shshi 08-14-2007 09:06 AM

Re: LADIES - Is there any other reason a pap
 
Hi,

There are many things that can cause an abnormal Pap test. Bacterial or yeast infections, herpes, trichomonas, using tampons before the test, having sex within 48 hours of the test, douching, etc. can all cause false results.

A Pap cannot, of itself, diagnose dysplasia or cancer. As mentioned previously, it is a screening test only. A biopsy will give the clear answer on what is going on.

Hugs,

Lisa

RouxWoman 08-14-2007 11:26 AM

Re: LADIES - Is there any other reason a pap
 
PiperPilot

"To answer your question, no, the only way a PAP result could suggest CIN 1,2,3 or cancer would be the presence of dysplastic cells."

So can I assume that if several biopsies are taken and they all come back negative that they are not looking in the in the right direction?

Do you know anything about a fungus? How does one get this, and does it go into the vagina or only stays on the surface of the skin?

You seem very knowledgeable, and I truly appreciate your information.

Thanks!

RouxWoman 08-14-2007 11:30 AM

Re: LADIES - Is there any other reason a pap
 
SHASHI,

Thanks again for your valuable input :)

"A biopsy will give the clear answer on what is going on."

This is what is problematic for me. I have had several biops and they all came back negative after the adnormal pap. This is why I ask if there are other issues that can cause a pap to be dx as HGSIL/ll. It is not making a lot of sense to me at this point.

Continue to do well, and thanks again.

RouxWoman 08-14-2007 11:35 AM

Re: LADIES - Is there any other reason a pap
 
FURTIVA,

"The main purpose of the PAP is look at drastical potential risky cervical changes, but it does detect other vaginal, ovarian, or endometrosis issues that might change the envirorment."

So, perhaps the dx from the pap could be coming from another area other than the cervix? Also, please forgive my ignorance, but what is endometrosis? Is that a form of cancer? how does one get that condition?

Thanks so much for your time and information.

furtiva 08-14-2007 01:24 PM

Re: LADIES - Is there any other reason a pap
 
Endometriois is the condition in which the tissue from inside of the womb implants on the surface of the ovaries, tubes, and uterus. It causes internal scarring, pelvic pain, painful periods, painful intercourse, and infertility.

Usage of tampons have been indicated as a cause for endo, because it blocks the passage of blood allowing the clots and tissues to get stuck in the reproductive organs.

A diagnosis of endometriosis is not made from an examination of the cervix, but, endometriosis can be suspected if there is a pattern to pelvic pain and pelvic examination reveals undue tenderness in the fornices (where the ovaries usually hang out).

You have to understand that the abnormal PAP means that there are envormental changes in your cervix or around it. Because the colpo omits dysplasia, and or irritation of cervix, these changes can be caused by other conditions.You may need further tests, including the ovaries and the canal (further up from your cervix) to determine what exactly is going on.

astw22 08-14-2007 09:13 PM

Re: LADIES - Is there any other reason a pap
 
Hi there I was having the same problem my paps kept coming back HGSIL but then the biopsies and ECC would come back negative so my doctor decided to do a CKC biopsy in order to biopsy cells higher up in the cervix. My results came back this week and its Mild/Moderate dysplasia with cervitis. I go for my follow up next week but im hoping I will not have any further problems after this. HTH

piperpilot 08-15-2007 09:18 AM

Re: LADIES - Is there any other reason a pap
 
Roux,

I'm unclear as to your question: are saying that you had an abnormal PAP result (please specify), followed by a colp/biopsy which returned negative for dysplasia? This is entirely possible--what specifically did the PAP result indicate? If PAP indicated ASCUS, and biopsy all negative, then you probably do not have dysplasia. Sorry to ask, but what is your age? If over 40, Abnormal Squamus Cell Unspecified Origin (ASCUS) may be produced by hormone level changes, and several other things. What did PAP indicate specifically? What causes you to suggest fungus?

RouxWoman 08-15-2007 01:53 PM

Re: LADIES - Is there any other reason a pap
 
[QUOTE=piperpilot;3156981]Roux,

I'm unclear as to your question: are saying that you had an abnormal PAP result (please specify), followed by a colp/biopsy which returned negative for dysplasia? This is entirely possible--what specifically did the PAP result indicate? If PAP indicated ASCUS, and biopsy all negative, then you probably do not have dysplasia. Sorry to ask, but what is your age? If over 40, Abnormal Squamus Cell Unspecified Origin (ASCUS) may be produced by hormone level changes, and several other things. What did PAP indicate specifically? What causes you to suggest fungus?[/QUOTE]

PiperPilot,


I had an abnormal PAP in February. This was the diagnoses:
ABFND PAP SMEAR HGSIL/CINll
There was no mention of "margins", "ASCUS", nor did the doctors mention any of these words.

They sent me for a colop and the doctor looked carefully and said several times that he could see nothing really abnormal but he took a biopsy from the 4 o'clock area. That sample came back negative.

They sent me for a LEEP (on what)? and then she said she would spare me the LEEP because she saw something, so she just took another biopsy and I heard her mention "4 O'clock." I told her that is where they took tissue from the first time!
That sample came back negative.

She scheduled me for a LEEP and this time they did the LEEP (on what)? That biopsy came back negative.

She said to come back in three months, and I did that and they did the colop and again took a biospy, and I am now waiting for those results. She said she wanted to be sure because it was unusual for a PAP to come back with that Diagnosis. I can understand that and want to get to the problem as well. I just wanted to be sure they were not taking biopsies from the same places they had already taken from.

I am past menopause (which I had not problems with), I am active and work in the entertainment/broadcasting industry, have no family history of cancer, have no unusual symptoms, and I do not have HPV. She did an internal exam, vaginally and from the rectum and said she did not feel anything unusual. It is very confusing, and of course has given me much stress from thinking it may be cancer someplace other than the cervix.

I mentioned "fungus" because a woman on another board said she had a fungus in her vagina and had problems because of it. I had never heard of a fungus in the vagina.

Thanks again for your response! I truly appreciate any and all advice/information I can get.:) :)

piperpilot 08-15-2007 02:35 PM

Re: LADIES - Is there any other reason a pap
 
I would request an HPV test to be sure that you do not have an HPV related condition. Since the biopsies were negative, and the LEEP biopsy of your whole transformation zone (I can only assume they took the transformation zone and not just a 4 oclock acetowhite leesion) was negative, it would appear that the the cytological changes were mischaraterized by the lab. this could be confirmed with a negative HPV test. If it's positive, then they may be looking in the wrong place for the dyplasia. I'll get back to you on this.

piperpilot 08-16-2007 10:46 AM

Re: LADIES - Is there any other reason a pap
 
Roux,

The only fungus (that I am aware of) that could cause abnormal PAP would be candida, like yeast and others. This would not likely cause a PAP to be read as dysplasia. I wish I could be of more help, but I would not be too concerned at this point, you are obviously staying on top of it. If you still have questions after you get your next biopsy result, you may want to contact a gyn/oncologist.

shiningstar521 08-16-2007 11:44 AM

Re: LADIES - Is there any other reason a pap
 
i got a bill yesterday from pathology for my three month REpap. The diagnosis code on it was 2331 ~ carcinoma in situ??? After my first leep i was diagnosed with this... is it really possible to tell from a pap that it was carcinoma in situ? i had my second leep done and now am waiting for my third and laparoscopy to be done. I don't want to wait *3* months for this if my PAP showed carcinoma in situ?!?!?!? anyone ever hear of this?!?!?

RouxWoman 08-16-2007 11:50 AM

Re: LADIES - Is there any other reason a pap
 
[QUOTE=piperpilot;3159237]Roux,

The only fungus (that I am aware of) that could cause abnormal PAP would be candida, like yeast and others. This would not likely cause a PAP to be read as dysplasia. I wish I could be of more help, but I would not be too concerned at this point, you are obviously staying on top of it. If you still have questions after you get your next biopsy result, you may want to contact a gyn/oncologist.[/QUOTE]

Piper,

Wow! I don't know what that woman had, and I keep going back to that site to see if she had posted more. Very strange.

Anyhoo, to answer your question, I do not have HPV. I was already tested for it, and the doctor I am seeing is an gyn/oncologist.

All I can do is wait, but frankly after reading what others have written on this site it seems that there is no clear cut answers most of the time.

Thanks for your help :)


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