High Grade Abnormality with no cervical lesions

Hi all! I'm new here. So glad I found this site-- i've been at the mercy of Mayo and webMD so I'm glad to finally have some real answers. 


I'm a little freaked out at the moment:

I started showing symptoms of HPV last year after an abnormal Pap test and colposcopy. All was mild/moderate until we decided to go to the LEEP in June of this past year. Pathology stated that the perimeter of the test sample was disease free whereas he said he could see the diseased cells in the center. 

My first appointment since then was last week with a pap smear. I got a call on Christmas Eve saying there was a high-grade abnormality in the tested area. 

Doctor said this is highly irregular. All cells appeared to be removed during the LEEP so we're both completely stymied by how my cells could be at high grade 6 months post-LEEP.

So we scheduled a colposcopy (today) and the doctor said he couldn't find any diseased cells on my cervix. At all. None. He even cleaned the area and did the vinegar test again. NOTHING. He said my cervix didn't even show any scar tissue. Doc was adorable when I told him the nurse practitioner who inserted my IUD said that my cervix looked beautiful. He obviously takes pride in his work. It made this a little easier to deal with. 

So he scraped the cells in the endo-cervix and took a couple other biopsies because it seems he was grasping at straws of...OK MAYBE there's something here. 

Doc said he may have to refer me to a gyn-oncologist to do the cone biopsy if the endocervix is showing the abnormalities. 

I hope they will have the results by Monday. 

I wonder if it's possible that my smear might be false. Is this possible?

I'm just so concerned about this. He didn't see any dysplasia. How can my pap show high-grade abnormality when it's not actually visible? 

Hi Amanda,

Welcome to the forums although I'm sorry for what you're going through. I'm no doctor, and it's good yours is looking into things for you. Firstly, unfortunately it is possible to have abnormality 6 months after LEEP (they call it LLETZ here in UK but its the same thing I believe) even when the margins are clear, although most women have no further problems after treatment. This is exactly what happened to me. If there was no mix up with your sample, it can come down to who examined the sample so I don't know if you're able to get a second opinion on that? If it proves that there is no abnormality in the biopsy, it may be the cells removed with the smear were the only ones that had changed so far. But like I say, I'm not a doctor. The important thing is that even if the results come back showing that there nothing, you make sure you go for your check ups. I don't know if this helps at all? I wish you all the best x



I have had a similar experience to you. My smear came back showing severe dyskaryosis and HPV. I went for a colposcopy and had a lletz done at the same time. The pathology came back from the tissue removed showing no abnormalities at all. My case was taken to the MDT monthly meeting where they reviewed my smear and lletz cells (I think they keep the slides), and they decided I should have another colposcopy. When I went for that, the Doctor had a look and could see no abnormalities. He took took a smear, scrapings from the endocervical canal and various biopsies. A week ago my results from these came back showing no abnormalities and no HPV. The consultant has written to me saying that my case will go back to the MDT meeting again due to the discrepancies, and they will let me know when they will see me again (likely for a smear only).

Although I feel the most enormous sense of relief, it has also left me feeling very confused. How can I have had severly abnormal cells and then less than 4 weeks later there are no abnormalities there at all? Are they missing something now or have they mixed my results up??

I too have found this site so useful, and it is probably the only reason I haven't gone mad- there are some truely lovely people on here.

Wishing you all the best.



That is so weird that the smear can come back with abnormality but nowhere else shows abnormality... It raises an alarm in my mind that there's something going on in the lab... 


EDIT: Biopsy came back normal: no abnormality in the endocervix or wherever they looked. My GYN is referring me to a Gyn-Oncologist for further ideas. I guess we'll wait and see what they say.

Thanks for your input! I'm wondering the same thing about the smear-area... maybe that's why everything looks clear but the cells that were taken for the smear were basically all removed... I guess we'll see what happens when my results come in.