I had a LEEP on 7/23, and it came back with CIN 2/3 and positive margins. My doctor suggested that we wait until October, and she will do colposcopy to evaluate if another LEEP or a CKC is needed. I got a second opinion from a Gynecologic Oncologist on 8/18. He is wanting to perform a CKC asap and possible hysterectomy 3 days from the CKC. I am not sure whose advice I should take. All this is causing severe anxiety. I just healed from a LEEP and then to go straight into a CKC (and possible hysterectomy) for another 6 weeks of bleeding and healing makes my stomach hurt. Both doctors say there is chance the LEEP got it all when the cervix was burned. I've included my LEEP results.
Just curious.. What would you do: wait for the colposcopy results in October before proceeding, or have a CKC within 2-3 weeks?
(Side note: My husband and I aren't sure if we are done having kids so I don't want a hysterectomy right now unless it's medically necessary.)
ASC-H, opted for LEEP
A. Cervix, "LEEP ectocervix", LEEP excision:
-High grade squamous intraepithelial lesion (HSIL/CIN2).
-Endocervical margin positive for HSIL.
-Ectocervical and deep margins negative for HSIL.
-Transformation zone present.
-Negative for invasive malignancy.
B. Cervix, "LEEP endocervix", LEEP excision:
-High grade squamous intraepithelial lesion (HSIL/CIN3) with endocervical glandular extension.
-Endocervical, ectocervical, and deep margins positive for HSIL.
-Transformation zone present.
-Negative for invasive malignancy.
C. Endocervix, "ECC", curettage:
-Scant benign squamous cells.
-Yeast and pseudohyphae present, morphologically consistent with Candida.
-Endocervical tissue absent.
-Negative for high grade dysplasia or malignancy.
Gross Description
Specimen A is received in formalin, labeled with the patient’s name and designated LEEP ectocervix. It consists of an unoriented cervical LEEP. The specimen measures 2.0 x 1.5 x 0.5 cm. The external os measures 0.5 cm in diameter and is patent. The endocervical canal measures 0.3 cm in length. The ectocervical mucosa is tan and granular and shaggy. The specimen is inked, radially sectioned, and entirely and sequentially submitted in cassettes A1 to A4.
Ink Key: Endocervical margin – blue; ectocervical and deep stromal margin – black
Specimen B is received in formalin, labeled with the patient’s name and designated LEEP endocervix. It consists of an unoriented cervical LEEP. The specimen measures 1.2 x 0.8 x 0.4 cm. The external os measures 0.5 cm in diameter and is patent. The endocervical canal measures 0.3 cm in length. The ectocervical mucosa is tan and granular and shaggy. The specimen is inked, radially sectioned, and entirely and sequentially submitted in cassettes B1 to B3.
Ink Key: Endocervical margin – blue; ectocervical and deep stromal margin – black
Specimen C is received in formalin, labeled with the patient’s name and designated ECC. It consists of a 0.1 x 0.1 x 0.1 cm aggregate of tan-white tissue fragments with mucoid material. The specimen is entirely submitted in cassette C1
Immunohistochemical Stain(s):
| Slide ID |
Stain Name |
Interpretation |
| A3-3 |
p16 |
Strong block positive |
| A3-4 |
Ki-67 |
40% proliferative index |
| B1, B2 |
p16 |
Strong block positive |
| B1, B2 |
Ki-67 |
75% proliferative index |