What is the most likely explanation for proceeding with cervical conization for this patient? A 42-year-old woman has a Pap smear as part of a routine health maintenance examination. There are no remarkable findings on physical examination. The Pap smear shows cells consistent with a high-grade squamous intraepithelial lesion (HSIL) with human papillomavirus subtype 18. Cervical biopsy specimens are obtained, and microscopic examination confirms the presence of extensive moderate dysplasia (CIN II) along with intense chronic inflammation with squamous metaplasia in the endocervical canal.
A. She is at risk for invasive carcinoma B. Human papillomavirus infection cannot be treated C. She is perimenopausal D. She has chronic cervicitis E. Her reproductive years are over
B. TiffneyComputer Engineer, M. Tech, Southeast Montgomery
Computer Engineer, M. Tech, Southeast Montgomery
Answered on Jan 28, 2019
Women should regularly see their gynecologist for their annual Pap Smear to see if there are anything wrong. Often times, the doctor will be able to spot any problems like cancer. If they can’t see it with the naked eye, then they can scrape a sample and have the sample examined.
At this point, they should definitely be able to determine if the woman has any problem including cancer. If a young middle-aged woman has a pap smear and it appears that she may have human papillomavirus subtype 18, there are certain things that the woman should understand. The doctor should explain to her that she is at risk for invasive carcinoma. That is because human papillomavirus leads to carcinoma which is a deadly cancer.
She is at risk for invasive carcinoma-(a) this patients cervical intraepithelial neoplasia (cin) ii may progress to invasive carcinoma in several years if not treated, particularly because she has a high-risk subtype of hpv. infection with hpv often drives this process, but the presence of hpv alone does not determine therapy.
hpv infection cannot be eradicated.
chronic cervicitis with squamous metaplasia is not a malignant lesion and does not determine therapy in this case.
the conization can preserve fertility in women who are of childbearing age.
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cervical conization (cpt codes 57520(cold knife) and 57522(loop excision)) refers to a biopsy of the cervix in which a cone-shaped sample of tissue is removed from the mucous membrane. conization may be used either for diagnostic purposes, or for therapeutic purposes to remove pre-cancerous cells.
cold knife conization (ckc). usually outpatient.
loop electrical excision procedure (leep). usually outpatient, occasionally inpatient.
conization of the cervix is a common treatment for dysplasia following abnormal results from a pap smear.