ÿþ<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3c.org/TR/1999/REC-html401-19991224/loose.dtd"> <html xmlns="http://www.w3.org/1999/xhtml" xmlns:v="urn:schemas-microsoft-com:vml" xmlns:o="urn:schemas-microsoft-com:office:office" xmlns:(null)0="http://www.w3.org/TR/REC-html40"><head><title>Rocky Mountain OB-GYN .::. Riverton, Wyoming</title> <meta content="text/html; charset=unicode" http-equiv="Content-Type"> <meta name="description" content=""> <meta name="keywords" content=""> <script language="JavaScript" type="text/javascript"> <!-- function clickmail(domain,mailto) { var url = "mailto:" + mailto + "@" + domain; self.location.href = url; return; } //--> </script> <link rel="stylesheet" type="text/css" href="styles.css"> <meta name="GENERATOR" content="Microsoft FrontPage 5.0"> </head> <body> <!-- DHTML Menu Builder Loader Code START --> <!-- <div style="POSITION: absolute" id="dmbri"> <img name="dmbif" alt="" src="layout/dmb_i.gif" width="1" height="1"> <img name="dmbjs" alt="" src="layout/dmb_m.gif" width="1" height="1"> </div> <script type="text/javascript"> var rimPath=null;var rjsPath=null;var rPath2Root=null;function InitRelCode(){var iImg;var jImg;var tObj;if(!document.layers){iImg=document.images['dmbif'];jImg=document.images['dmbjs'];tObj=jImg;}else{tObj=document.layers['dmbri'];if(tObj){iImg=tObj.document.images['dmbif'];jImg=tObj.document.images['dmbjs'];}}if(!tObj){window.setTimeout("InitRelCode()",700);return false;}rimPath=_gp(iImg.src);rjsPath=_gp(jImg.src);rPath2Root=rjsPath+"../";return true;}function _purl(u){return xrep(xrep(u,"%%REP%%",rPath2Root),"\\","/");}function _fip(img){if(img.src.indexOf("%%REL%%")!=-1) img.src=rimPath+img.src.split("%%REL%%")[1];return img.src;}function _gp(p){return p.substr(0,p.lastIndexOf("/")+1);}function xrep(s,f,n){if(s) s=s.split(f).join(n);return s;}InitRelCode(); </script> <script type="text/javascript"> /* <![CDATA[ */function LoadMenus() {if(!rjsPath){window.setTimeout("LoadMenus()", 10);return false;}var navVer = navigator.appVersion; if(navVer.substr(0,3) >= 4) if((navigator.appName=="Netscape") && (parseInt(navigator.appVersion)==4)) { document.write('<' + 'script type="text/javascript" src="' + rjsPath + 'nsmenu.js"><\/script\>'); } else { document.write('<' + 'script type="text/javascript" src="' + rjsPath + 'iemenu.js"><\/script\>'); }return true;}LoadMenus();/* ]]> */</script> DHTML Menu Builder Loader Code END --> <div align="center"> <table border="0" cellspacing="0" cellpadding="0" width="800"> <tbody> <tr> <td height="171" width="413" align="left"> <img id="MenuSpacer" name=MenuSpacer alt=MenuSpacer src="layout/spacer.gif" width=413 height=62><img border=0 alt="Rocky Mountain OB-GYN" src="layout/logo.jpg" useMap=#Map align="left" width="339" height="77"><br> &nbsp;<p>&nbsp;</p> <p>&nbsp;</td> <td height="171" width="387" align="center"> <br> <font face="Arial" size="4">To better understand these abnormalities<br> <br> <a href="anatomy-1.htm">GO TO ANATOMY PAGE</a></font></td> </tr></tbody></table> <table class="body-table-right-bottom" border="0" cellspacing="0" cellpadding="0" width=800> <tbody> <tr> <td valign="top" background="layout/body-bg-left.jpg" width="8" align="left" bgcolor="#A75F5F"> <img alt="Rocky Mountain OBGYN" src="layout/body-top-left.jpg" width="8" height="27"><img alt="Rocky Mountain OBGYN" src="layout/spacer.gif" width=8 height=400></td> <td class="body-bg" valign="top" colspan="2" align="left"> <table border="0" cellspacing="0" cellpadding="10" width="790"> <tbody> <tr> <td valign="top" align="left"> <font size="5">What does my Abnormal Pap Smear mean?</font></td> <td valign="top" width="200" align="left"> <p align="center"><font size="5">Result</font></td></tr> <tr> <td valign="top" align="left"> <p class="body-text"><font size="3"><b>ASCUS</b> stands for &quot;<u><b>A</b></u>typical <u><b>S</b></u>quamous <u><b>C</b></u>ells of <u><b>U</b></u>ndetermined <u><b>S</b></u>ignficance.&quot;&nbsp; In simple terms, the cells are not quite right, but their appearance does not definitely point to pre-cancerous change.&nbsp; The cells might be recovering from an infection, or they could be on the first step of the ladder toward something more serious.&nbsp; </font></td> <td width="200" align="center"> <p align="center"><b><font size="4" face="Arial">ASCUS</font></b></td></tr> <tr> <td valign="top" align="left"> <hr> <font size="5">What we do about it...</font></td> <td valign="top" width="200" align="left"> <hr> <p align="center">&nbsp;</td></tr> <tr> <td valign="top" align="left"> <font face="Arial">Guidelines called &quot;algorithms&quot; have been developed by organizations of specialists, and we use them to help direct our next steps to evaluate abnormal pap smears.&nbsp; It is difficult to explain in a simple way the many possibilities for evaluation.&nbsp; In general, an ASCUS pap smear will have HPV testing automatically done in women over 20. If the HPV test is positive, it will be evaluated with a colposcopy.&nbsp; Women under 20 do not need HPV testing and generally do not have further evaluation.</font></td> <td valign="top" width="200" align="left"> <p align="center"> <img border="0" src="images/HPV%20virus.jpg" width="90" height="97"></td></tr> <tr> <td valign="top" align="left"> <hr> <b><font face="Arial">ASC-H</font></b><font size="3"><font face="Arial"> stands for &quot;<u><b>A</b></u>typical <u><b>S</b></u>quamous <u><b>C</b></u>ells -- <u><b>H</b></u>igh Grade&quot;&nbsp; In this category, the degree of abnormality is greater.&nbsp; The cells are still not obviously pre-cancerous but there are sufficient changes to <u>suspect</u> that there may be a &quot;higher grade lesion&quot; -- some effect from a High Risk HPV infection.&nbsp; Colposcopy is the next step.</font></font></td> <td valign="top" width="200" align="left"> <hr> <p align="center"><b><font size="4" face="Arial">ASC-H</font></b></td></tr> <tr> <td valign="top" align="left"> <hr> <p><font face="Arial"><b>LGSIL </b>stands for <u><b>L</b></u>ow <u><b>G</b></u>rade <u><b>S</b></u>quamous <u><b>I</b></u>ntraepithelial <u><b>L</b></u>esion.&nbsp; Pathologists typically &quot;grade&quot; tissue abnormalities.&nbsp; A low grade tumor has a better prognosis than a high grade tumor.&nbsp; In the cervix tissue (see the Anatomy Page) the HPV causes changes in the cells; the cells come from an abnormal area or &quot;lesion&quot;.&nbsp; In this category, the cells are more benign in appearance than a high-grade lesion.&nbsp; However, they reflect HPV infection, most likely a High Risk Type.&nbsp; Consequently, the cells (from the Pap) are not automatically tested for HPV-DNA.&nbsp; Again, colposcopy is usually the next step.</font></td> <td valign="top" width="200" align="left"> <hr> <p align="center">&nbsp;<p align="center"><b><font face="Arial" size="4">LGSIL</font></b></td></tr> <tr> <td valign="top" align="left"> <hr> <b><font face="Arial">H</font></b><font face="Arial"><b>GSIL </b>stands for <u><b>H</b></u>igh <u><b>G</b></u>rade <u><b>S</b></u>quamous <u><b>I</b></u>ntraepithelial <u><b>L</b></u>esion.&nbsp; This abnormality is quite worrisome and needs further evaluation soon.&nbsp; In fact, when present in women over 20, it may be evaluated by going directly to an excisional biopsy procedure (such as a LEEP or a cone biopsy) or colposcopy and biopsy. </font></td> <td valign="top" width="200" align="left"> <hr> <p align="center"><b><font face="Arial" size="4">HGSIL</font></b></td></tr> <tr> <td valign="top" align="left"> <hr> <font size="3" face="Arial"><b>AGCUS</b> stands for &quot;<u><b>A</b></u>typical <u><b>G</b></u>landular <u><b>C</b></u>ells of <u><b>U</b></u>ndetermined <u><b>S</b></u>ignficance.&quot;&nbsp; Cells collected in the pap smear can be from skin (squamous) tissue or glandular tissue.&nbsp; (It would help to check the anatomy page.)&nbsp; The gland tissue can be from the lining of the cervical canal, or from the inside lining of the uterus.&nbsp; HPV can cause cancers of both skin and gland tissue.&nbsp; In older women, it's possible that pre-cancerous cells of the uterine lining (endometrium) can be sloughed off and show up on the pap smear.&nbsp; The age of the patient affects next steps for evaluation.</font></td> <td valign="top" width="200" align="left"> <hr> <p align="center"><b><font size="4" face="Arial"><br> AGCUS</font></b></td></tr> <tr> <td valign="top" align="center"> <font face="Arial"><a href="colpo-bx.htm">Next: Colposcopy &amp; Biopsy</a>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; <a href="pap-central.htm">Back to Pap Smear Central</a></font></td> <td valign="top" align="center"> <font color="#005591" face="Arial"><a href="anatomy-1.htm">Anatomy Page</a></font></td> </tr></tbody></table></td></tr></tbody></table> <table border="0" cellspacing="0" cellpadding="0" width="798"> <tbody> <tr> <td colspan="3" align="middle"><br><br><a href="./"><span class=footer-links>HOME</span></a> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp; <span class=footer-links>:</span> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; &nbsp; <a href="practiceareas.aspx"><span class="footer-links">PRACTICE AREAS</span></a> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 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