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Low Grade Squamous Intraepithelial Lesion

An LSIL or a low grade squamous intraepithelial lesion is a kind of abnormal development of squamous cells on the uppermost layer of the cervix. Squamous cells are flattened forms of epithelial cells that look like scales. Epithelial cells are those cells which aid the absorption, movement and distribution of certain nutrients and liquids in the body. The cervix is a tiny organ that is shaped like a cylinder and is a part of the lower end and neck of the uterus. The uterus is a hollow gland that is present in a female body, where implantation of an egg and development of fetus occurs.

There are high grade squamous intraepithelial lesion and low grade squamous intraepithelial lesions. Here, the terms low and high grade refer to the appearance of the abnormal cells as well as the total area of cervix affected by them. A low grade LSIL is one wherein a small section of the cervix is affected and the cells have low levels of abnormality. On the other hand, a high grade squamous intraepithelial lesion or an HGSIL is one wherein a large section of the cervix is affected and the cells are severely abnormal.

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Low Grade Squamous Intraepithelial Lesion Symptoms

In its early stages, there are no noticeable signs.  But as the  lesion develops there are symptoms in the form of  itching and inflammation  in more than 50 percent of the cases.

Foul smelling discharge and bleeding is also a symptom of low grade squamous intraepithelial lesion. The lesions in the early stages look like inflammation on the skin, and then they take on the shape of a lump which then becomes ulcerated and rigid.

Causes of LSIL

  • Low grade squamous intraepithelial lesions are normally caused by infections or due to healing of a minor injury. Occasionally, the cause of the condition cannot be ascertained.
  • It may be noted that presence of LSIL do not signify the occurrence of cancer. Cancer refers to the abnormal development of a new tissue that features unregulated growth of cells with anomalistic structures and whose appearance is more basic or primitive. The occurrence of low grade squamous intraepithelial lesions indicate alterations in cells which may happen before the presence of cancer. Hence, an LSIL serves as a warning that cervical cancer may form in the future.
  • It is important to note that the possibilities of an LSIL lesion presence getting detected on a Pap smear, wherein invasive cervical cancer is already present, is less than one percent. Additionally, less than one percent of women affected by LSIL which is detected on a Pap smear, will be afflicted with cervical cancer within the next two years.

Low Grade Squamous Intraepithelial Lesion Risk Factors

The presence of LSIL in the cervix does not imply that the person is presently having cancer. Nonetheless, it is a a warning sign that a cancer may happen in the near future.  These lesions are mostly found in women in post menopause, though it has been noticed that the risk factors in younger women have also increased.  The possible risk factors for Low grade squamous intraepithelial lesion are human papillomavirus (HPV) infection,human immunodeficiency virus (HIV), smoking, immunosuppression, bartholin’s gland cancer, malignant melanoma and vulvar sarcoma.

LSIL Diagnosis

  • An obstetrician and/or a gynecologist will perform the different diagnostic tests to determine the presence of low grade squamous intraepithelial lesions. A Pap smear or a colposcopy is used to diagnose this condition.
  • A colposcopy involves visual investigation of the cervix and the vagina via a magnifying machine with a light, called a colposcope. A Pap smear is a kind of test that is used to verify abnormal alterations in cells. This is conducted by scraping off the loose cells occurring in the cervix and smearing or spreading them on a glass slide, which is later examined under a microscope.
  • However, it may be noted that doctors will definitely be able to diagnose presence of an LSIL via a biopsy that is performed during a colposcopy. A biopsy refers to a process which involves the removal of living cells or tissues from the glands and other areas of the patient’s body, which are later investigated under a microscope or in a culture (which is an artificial method to grow tissues or cells in a lab). This will help in the diagnosis, as well as in following the course of the condition and /or to come up with a  prognosis.

Low grade squamous intraepithelial lesion – treatment

  • Low grade squamous intraepithelial lesions can occasionally disappear on their own without any treatment. However, the treatment option is generally decided after diagnosis of the condition. If LSIL is detected, most doctors choose to remove them rather than wait for them to fade away, as such lesions carry the probability of progression into cancer.
  • The treatment of low grade squamous intraepithelial lesion is aimed at destruction and/or removal of the abnormal cells occurring in the cervix and thus facilitate the process of the growth of healthy cells in those sections where abnormal cells were found to be occurring.
  • LSIL can be destroyed by various methods such as application of sub-freezing temperatures on them, the use of lasers or via the application of electrical currents or heat therapy.
  • It is however important to note that freezing therapy is not used as an option when the condition occurs within the cervical canal. This therapy is mostly used in cases of tiny sections of abnormality that have not entered the cervical canal. Larger sections of cervix affected by LSIL are usually treated via heat, laser or electrical current therapy. If the abnormalities are more than half an inch from the cervical bone, measure more than an inch in width, and/or occur in more than two quadrants of the cervix, then they are termed as low grade squamous intraepithelial lesions affecting large parts of the cervix.
  • Total removal of the affected tissue parts can be done via surgery.

LSIL Prevention

Abstaining from sexual intercourse with multiple partners and having safe sex can help in reducing the risk of Low grade squamous intraepithelial lesion.

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