LEEP Results

Pickle Eyes

:wrinkles brow:

With CIN3, I suggest you consider going to a gynecological oncologist. They are trained to know about such things because they deal with it every day.

I'm curious about the "endocervical glands" comment. That sounds to me like it involves the glandular/conical cells in the upper 2/3 of the cervix. Those atypical cells do not spread out like squamous atypical cells. If it were me, I'd ask for more clarification on what that means.

Did you go to the doctor or did you just receive the report? Write back soon!

Kell1960

I talked to Cindy (gyn nurse) on the phone. She said I don't know how much to tell you. I said just read the report to me. She said Cin3. I asked if my margins were clear. She said no, let me talk to Doc L. and see what she wants to do. I asked her some other things.

It was like pulling teeth to get answers.

She called me back and said Doc wants to do a pap in six months. I said so my margins are clear then? Cindy said yes. (After telling me earlier they weren't clear). I said I'm not sure I'm comfortable with waiting 6 months. Cindy said well Doc L knows your history and just read the pathology report and that's what she recommends.

Also I'm a bit confused. When I had my colpo with ECC, the ECC scrapings came back Cin3 and carcinoma in situ in my endocervical canal. The LEEP report says nothing about carcinoma in situ. Does that mean the carcinoma in situ is gone?

This is my whole pathology report word for word. I went to the office and picked it up after talking to Cindy.

Surgical Pathology: Cervix-LEEP.

Diagnosis: Squamous intraepithelial lesion, high grade (CIN3), cervix, LEEP. Margins positive. Cin involves endocervical glands.

Microscopic: The cervical LEEP contains a high grade Squamous intraepithelial lesion with severe dysplasia (Cin3). The lesion involves endocervical glands and is present at the cauterized margins.

Pickle Eyes

Hmmm, I still suggest you go to a gyn/onc if you can.

I got flash backs from when I received my results from my ECC. The nurse started to read, then she paused (after she adenocarcinoma in situ). Then she said, "you need to come in and see Dr. H." They wouldn't give me a copy of the actual report until AFTER I spoke with the doctor.

The thing that concerns me is that the endocervical glands are involved. Those are mucous secreting glands, as I understand it (not lymph nodes). If the mucous secreting glands are involved then I thought that was glandular/columnar (and therefore could be adenocarinoma-type involvement).

Can you make an appointment with your doctor just to go over the pathology report?

When I had my cold knife cone biopsy, I learned the difference between those and LEEP procedures. They both remove a cone shaped piece of the cervix. They both remove tissue that can be biopsied. The LEEP singes the edges of the tissue (biopsied tissue and the intact cervix). This reduces bleeding post procedure. The cold knife cone is a clean cut. The edges are intact (on biopsied and cervix). Margins/edges are clear on a cone, but not on a LEEP. I suspect my doctor did the cone instead of a LEEP because she expected it to be cancer (since my ECC came back adenocarcinoma in situ).

I don't know what else to tell you right now. I hope you can call your doctor tomorrow and maybe get some more answers.

Take care of yourself!

Kell1960

I know what I can do. I work in a hospital. I was just looking at my pathology report and I know the doc who did the pathology and signed off on it. I'll take my report to work with me tomorrow and ask him to explain the endocervical gland involvement.

redgl37

Hi Kelli1960 - I had a report of findings almost exactly like yours - I work for a rad onc dr who said i was ok to just keep having my pap every 3 mo's (which I'm about to do my 3rd 3 mo appt next week) and so far i have been told everything is ok - but like you i had several diff dr's look at the results - he said i could see a specialist but my ob-gyn was doing well with the info she had so i've decided to stick w/ her until i hear otherwise from other dr's. I too am curious about the glandular involvement as my report said the same thing. Good luck with yours today and asking about it. It can be so nervewracking at times!! Kristin

Kell1960

Thanks Kristin,

I didn't get a chance to ask. Pathologist took the day off. Hopefully I will see him Monday and can ask about the gland involvement.

Steph8681

Kelly,
My path report says that too. I also had CIN 3 and it spread to the rest of my vagina as well as to the the endo cervical lid and "glands." All in-situ means is that it is not yet invasive cancer--it means that it is still contained to the surface and has not moved beyond the surface to infect the rest of the underlying cells. Pickle eyes is right about the glandular invlovement but I would not rest my hat on it being gone. My doc just dropped the bomb on me that they didn't get it all. A pap every six months as a launching point from your LEEP is a little long, especially for CIN 3. The usually is every 3 months for a while and then you can fade out from 6 months to one year. I would twist your doc's arm a little harder if I were you. Good luck sweetie.

BE 123

AIS and glandular involvement are not the same. I thought they were, but found articles saying otherwise. It's very confusing. I hope some pathologists don't use the terms interchangeably because then my info is wrong. My lesion was on the ectocervix, but involved "endocervical mucosa." I still don't entirely know what that was all about but any mention of "endocervical" makes me extremely nervous.

There is also a mixed lesion, "adenosquamous," that is rare (rarer than adenocarcinoma, which isn't even rare anymore). Can't seem to find good data about it other than that it is very aggressive.

Glandular involvement or gland duct involvement occurs alongside squamous lesions, typically high grade lesions, but as you all know high grade lesions can coexist with low grade lesions (more than one lesion, etc.) I can't visualize it, but it's characterized by loss of cellular polarity causing cells looked "piled onto" one another.

Anyway, I would like to know more as it is not well-defined even amongst professionals, and will ask my gyn when I see her next time.

Pickle Eyes, how are you doing? If you are still reading this thread. How frequent do you return for checkups, and do your checkups involve paps or colpos or even both? I am still amazed and delighted how "on the ball" your doc was. Hope this post doesn't get zapped for threadjacking.

Pickle Eyes

That is soooo good to know that AIS and glandular involvement are not the same. Like you, the endocervical involvement is concerning. The only way the doctors can get a good idea of what is going on up there is with a LEEP or cone. Kind of scary!

I'm doing well, Brieaukirsch. I will be seeing my doctor every 3 months for a year or two, then every 4 months for a year or two, then every 6 months for 5 years. It seems a bit much - spanning over the next 7-9 years, but I'd rather my doctor be cautious than brush me off. I don't know what my followup appointments will involve. I'm prepared for a colpo, but suspect it will be a pap. :shrugs: I could call and find out, but I don't want to worry about it yet . . . I'll wait until a few days before!

All of that brings me back to the original post. I'd much rather a doctor be cautious and proactive in the testing and catch stuff (like my doctors did) than to find things later on when they are in worse condition. I feel blessed to have the doctors I've had (regular doc, gyn, AND the gyn/onc).

lisaann

so i am really confused about my leep cone biopsy results..

the report states that all marfins clear/free of dusplasoa cin 3 but they do say that sever squamous dysplasia cin 3 extending to endocervical glands margins free of dysplasia now my dr. wants to see me back on dec. 20 for a follow up and then do the wait and see thing screnning me every 3 months for pap test is this right??? do i need more surgery??? i dont think my dr. is being strainght forward with me what should i do? any advise would be appreasiated..

thanks lisa