Gynecology Book

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High Grade Squamous Intraepithelial Lesion

Aka: High Grade Squamous Intraepithelial Lesion, HSIL, HGSIL, CIN 2, CIN 3
  1. Evaluation: HSIL identified on Pap Smear
    1. Step 1: Colposcopy
      1. Adequate Colposcopy requires visualization of SCJ
      2. Colposcopy adequate if SCJ fully visualized and
        1. Lesion not identified and ECC completed or
        2. Lesion responsible for abnormal pap was found
      3. Refer if inadequate Colposcopy
        1. Review diagnostics
        2. Consider LEEP
    2. Step 2a: Interpret Colposcopy in non-pregnant women
      1. Biopsy confirmed CIN 2 or 3: Manage per guidelines
        1. See Colposcopy Protocol
      2. Biopsy with CIN I or no CIN
        1. Reevaluate diagnostic results
        2. Consider LEEP
    3. Step 2b: Interpret Colposcopy in pregnant women
      1. Delay LEEP until after pregnancy
        1. Low risk of progression in pregnancy
        2. Lesions often regress in postpartum period
        3. Yost (1999) Obstet Gynecol 93:359-62
      2. Exception: Suspected invasive disease
  2. Follow-up: After excision of HGSIL
    1. Pap Smear with Colposcopy
      1. Repeat every 6 months for 1 year
      2. Negative for ASCUS or greater: Annual Pap Smears
      3. Positive for ASCUS or greater: Continue with Colposcopy and Pap Smear every 6 months
  3. References
    1. Apgar (2009) Am Fam Physician 80(2): 147-55
    2. Apgar (2004) Am Fam Physician 70:1905-16
    3. Wright (2002) J Low Genit Tract Dis 6:127-43

High-grade squamous intraepithelial lesion (C0333875)

Definition (NCI) A precancerous neoplastic process characterized by the presence of moderate or severe dysplastic cytological changes which extend to the upper part of the squamous epithelium. Maturation at the surface of the squamous epithelium may or may not be present. Representative examples include the high grade esophageal squamous intraepithelial neoplasia, high grade cervical squamous intraepithelial neoplasia, high grade vaginal intraepithelial neoplasia, and high grade vulvar intraepithelial neoplasia.
Definition (NCI) Cells of the uterine cervix that are moderately or severely abnormal and may become cancer.
Concepts Neoplastic Process (T191)
SnomedCT 22725004
Spanish lesión intraepitelial escamosa de alto grado, lesión intraepitelial escamosa de alto potencial maligno (anomalía morfológica), lesión intraepitelial escamosa de alto potencial maligno, HSIL, Lesión intraepitelial escamosa de alto grado, lesión intraepitelial escamosa de gran malignidad (anomalía morfológica), lesión intraepitelial pavimentosa de gran malignidad, lesión intraepitelial escamosa de gran malignidad, lesión intraepitelial pavimentosa de alto potencial maligno
Dutch hooggradige squameuze intra-epitheliale laesie, HSIL
French Lésion épidermoïde intra-épithéliale de haut grade (HSIL), Lésion épidermoïde intra-épithéliale de haut grade
German HSIL, High grade squamous intraepithelial lesion
Italian Lesione intraepiteliale squamosa di grado elevato, Lesioni intraepiteliali squamose di alto grado (HSIL)
Portuguese Lesão intra-epitelial por células escamosas de alto grau, HSIL
Japanese 高度扁平上皮内病変, ＨＳＩＬ, ｺｳﾄﾞﾍﾝﾍﾟｲｼﾞｮｳﾋﾅｲﾋﾞｮｳﾍﾝ, HSIL
Czech Šupinatá intraepitelová léze vysokého stupně, HSIL
English high grade squamous intraepithelial lesion (HGSIL), hsil, high grade sil, High grade SIL, High-grade squamous intraepithelial lesion, HSIL, High-grade squamous intraepithelial lesion (morphologic abnormality), high-grade squamous intraepithelial lesion, high-grade squamous intraepithelial neoplasia, High-Grade Squamous Intraepithelial Lesion, High Grade Squamous Intraepithelial Neoplasia, High grade squamous intraepithelial lesion
Hungarian Súlyos fokú intraepithelialis squamosus laesio, HSIL
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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