Negative For Intraepithelial Lesion or Malignancy: Decoding

Cervical cancer screening is crucial for preventing cancer in general and catching cancer early. For this, two tests are done. The Pap test (also called a Pap smear) checks for cell changes in a woman’s cervix that can lead to cancer if left untreated. The other test is the HPV test, which checks for human papillomavirus (HPV) that can cause cell changes and lead to cervical cancer. After you have a Pap test, you may want to check the results of your Pap test. The phrase “negative for intraepithelial lesions or malignancies” may be confusing, but this is the medical term used to report that your Pap test is normal or negative. This means that there are no signs of cancer, precancer, or other abnormalities. Here, “intraepithelial” defines the location within the cells that form the surface of the cervix. A lesion is the tissue that has been affected, and a malignancy refers to the presence of cancer cells that can spread to other parts of the body and damage tissue. Read this article to learn some known facts about negative intraepithelial lesions and malignancies.

What is a Pap smear test and how is it performed?

A Pap smear, also known as a Pap test, is a procedure used to screen women for cervical cancer. It tests for the presence of cancerous or precancerous cells in the cervix (the lower part of the uterus). In this process, cells are taken from the cervix and examined in detail under a microscope in a laboratory. How is a Pap smear done? The test is a little uncomfortable but very quick. Here’s how your doctor will perform the test:

• First, your doctor will insert a speculum (a plastic or metal instrument that opens the vagina wide to help get a clear view of the cervix) into your vagina.
• A brush or spatula is used to obtain a sample of cells and cervical mucus from the cervix.
• The sample is then examined under a microscope in a laboratory to look for abnormal cell growth.

How are Pap test results reported?

The most commonly used system isBethesda Systems“Pap test” is used to describe the results of a Pap test. There are three categories for reporting this test, with several subcategories:

• Negative for intraepithelial lesion or malignancy
• Epithelial cell abnormalities
• Other malignant tumors

If your Pap test reveals abnormalities, further testing may be needed.

Negative for intraepithelial lesion or malignancy

Cytology results: If the test is negative for intraepithelial lesions or malignancies, there are no signs of precancerous conditions, cancer, or other abnormalities. However, there may be findings unrelated to cervical cancer, such as signs of infection with yeast, Trichomonas vaginalis, or herpes. Additionally, some women’s mucus samples may show “reactive cell changes.” This occurs when there is inflammation or infection around the cells of the cervix.

Epithelial cell abnormalities

This indicates that cells on the surface of the cervix have changed into precancerous or cancerous cells. This category has two subcategories: squamous cells and glandular cells.

Squamous cell abnormalities

There are two types of abnormalities in this category: atypical squamous cells (ASC) and squamous intraepithelial lesions (SIL).

Atypical squamous cells (ASC): There are two types of abnormalities in this category: atypical squamous cells (ASC) and squamous intraepithelial lesions (SIL).

• Atypical squamous cells of undetermined significance (ASC-US): Used to indicate the presence of abnormal cells but cannot determine if they are precancerous, caused by infection, or inflammation. Cells marked as ASC-US are usually not precancerous and require additional screening, such as an HPV test, to be sure.

• High-grade atypical squamous cells (HSIL): Used to describe the presence of abnormal cells that may be caused by a precancerous condition. Additional screening may be required and treatment may be required.

Squamous intraepithelial lesions (SIL): If your Pap test results show SIL, further testing is needed. Treatment may be needed to help prevent cancer from developing. A risk factor that can cause cervical cancer is HPV. studyApproximately 46,711 cancer cases are identified each year in the United States, of which 37,000 are caused by HPV. This category contains two subcategories:

• Low-grade SIL (LSIL): The cells look slightly abnormal but not cancerous. Other tests, such as a biopsy, can help. The cells go back to normal without treatment. These cells are sometimes called “mild dysplasia” or “cervical intraepithelial neoplasia grade 1.”
• High-grade SIL (HSIL): The cells seem very abnormal. If left untreated, there’s a high chance that these cells will turn into cancer cells. That’s why your doctor may recommend other tests, such as a biopsy. This is sometimes called “moderate to severe dysplasia” or cervical intraepithelial neoplasia grade 2 or 3.

Glandular cell abnormalities

• Atypical glandular cells: In this category, the glandular cells look abnormal and show characteristics of cancer. In this case, your doctor may recommend further testing.
• Adenocarcinoma: Adenocellular carcinoma is known as adenocarcinoma. Specialists will examine the cells to see if this type of cancer originates in the uterus, cervix, or other parts of the body.

Other malignant tumors

There are reports of other types of cancer in this category that rarely affect the cervix. These types of cancer include lymphoma, melanoma, and sarcoma.

What does it mean to be negative for intraepithelial lesions or malignancies?

A negative Pap test for intraepithelial lesions or malignancies means that there are no cancerous or precancerous cells in the cervix. Additionally, no evidence of abnormalities is shown. All glandular and squamous cells seen during the test are normal cellular material. This is a normal or negative report. The types of cells that undergo a Pap test include:

• Surface squamous cells
• Intermediate squamous cells
• Squamous metaplastic cells
• Parabasal cells
• Cervical Cells
• Mature squamous metaplasia
• Immature squamous metaplasia

Other normal cells commonly seen on a Pap test include:

• Ciliated cervical cells
• Endometrial cells

How does a pathologist make this diagnosis?

Pathologists utilize Pap tests to diagnose negative for intraepithelial lesions or malignancies. This test is done on a sample taken from the cervix which a pathologist or clinical laboratory technician examines under a microscope. Such a test will show several types of normal cells, including endocervical cells, squamous cells, and metaplastic cells. For diagnosis, pathologists will use enough squamous cells. The presence of endocervical cells or metaplastic cells is considered a good indicator, but they do not have to be present in every sample. A Pap test may find normal cells of the endometrium or rare infectious elements such as viruses, yeast, or bacteria.

What does it mean to be negative for intraepithelial lesions or malignancies but positive for HPV?

A negative intraepithelial lesion or malignancy but positive HPV means that there are no precancerous or cancerous cells, but HPV infection may be present. Other findings that may be unrelated to cervical cancer, such as infection or inflammation around the cervical cells, can also indicate HPV in a Pap test result. Infection and inflammation in the cells of the cervix are due to “reactive cell changes.” Therefore, even if the Pap smear test is negative, there may be changes in the cervical cells that result in a report of HPV infection. Therefore, you should have a Pap test and an HPV test every three years.

What does it mean to have a negative intraepithelial lesion or reactive cellular changes for malignancy?

A negative result for intraepithelial lesions or reactive cell changes for malignancy indicates that there is inflammation or infection around the cervical cells located in the cervix. Inflammation may be due to a cellular response to injury or cell death. It may also be due to the white blood cells seen in a Pap test. Meanwhile, infection around the cervical cells may be due to yeast or human papillomavirus (HPV). In these cases, your healthcare professional will recommend further testing.

What does it mean if an inflammatory smear is negative for intraepithelial lesions or malignancy?

An inflammatory smear that is negative for intraepithelial lesions or malignancies means that there is inflammation in the cells of the cervix, which can be confirmed by a Pap test. So, if a Pap test finds inflammatory cells in the cervix, it indicates the presence of some white blood cells (WBCs). Inflammation of the cells of the cervix is ​​common and usually not a problem. However, experts recommend further testing in such cases.

What does it mean to be negative for intraepithelial lesions or malignancy and negative for mild and moderate inflammation?

A negative Pap test for intraepithelial lesions or mild inflammation for malignancy does not indicate any specific disease or injury. Therefore, in such cases, there is no need for regular treatment. Mild inflammation of the cells of the cervix may be due to certain factors. They include exogenous hormones, especially those found in oral contraceptives, and menopausal hormone replacement therapy, which may cause the columnar epithelium (a single layer of columnar epithelial cells found in the stomach and intestines) to turn inside out. On the other hand, a negative Pap test for intraepithelial lesions or malignancy and moderate inflammation indicates a sign of infection by yeast or HPV. Therefore, your doctor may suggest a pelvic exam to diagnose the infection. This will also help determine the appropriate treatment plan to prevent such types of inflammation.

Final thoughts

A Pap test is a procedure used to screen for cervical cancer in women. It helps to check for the presence of cancerous or precancerous cells in the cervix. A Pap test report is explained with the phrases “negative for intraepithelial lesions or malignancies”, “epithelial cell abnormalities”, and “other malignancies”. Now, regarding the phrase “negative for intraepithelial lesions or malignancies”, this category does not show any signs of precancer, cancer, or other abnormalities. However, you may see some findings that are not related to cervical cancer, such as infection or inflammation around the cells of the cervix. In such cases, your doctor will recommend further testing to prevent the possibility of developing cervical cancer.

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