Low grade squamous intraepithelial lesion develops when the cervical squamous cells start to multiply and act differently. The abnormalities are somehow mild, affecting only a small part of the cervix, thus causing mild to no symptoms at all. However, symptoms are manifested when the abnormal squamous cells continue to grow resulting in lumps to appear that would later harden and become ulcerated. Continuous progression of low-grade squamous cell lesions could result in full blown cervical cancer.
Low grade squamous intraepithelial lesion can be managed effectively if detected early, usually through Pap smear. In fact, treatment is sometimes not necessary because the precancerous lesion resolves on its own. Still, the doctor may choose to further investigate the lesion and decide to remove it to prevent it from developing into cancer. Treatment is geared towards eliminating abnormal cells to give way for healthy new squamous cells.
Causes of low grade squamous intraepithelial lesion
Low grade squamous intraepithelial lesion (LGSIL) arises due to subtle abnormalities in the squamous cells which affect a small part of the cervix only. Squamous cells can be found on different parts of the body but they are highly plentiful in the cervix. These flat plate-like epithelial cells help in the absorption and distribution of nutrients and fluids all over the body. Squamous cells also come in different types based on the number of layers they have. Those with only one layer are called simple squamous epithelium while those with multiple layers are called stratified squamous epithelium. The stratified variety has multiple overlying squamous cells and basal cuboidal cell layers.
Experts are still trying to understand LGSIL. But recent medical studies showed that squamous cells begin to exhibit abnormalities following a minor cervical injury or HPV infection.
- Minor cervical injury
The subsequent healing process after a minor cervical injury has been found to cause cervical squamous cells to grow rapidly which is abnormal.
- HPV infection
Human papillomavirus infection, which can be transmitted through sexual intercourse, may cause abnormalities in cervical squamous cells as well. HPV thrives in the cervix and disrupts the normal activities of cervical squamous cells.
While these are two of the known causes of low grade squamous intraepithelial lesion, the exact origin of the disease remains unidentified in some individuals. However, a woman can increase her chances of getting LGSIL if she is:
- A Smoker
- Has multiple sexual partners
- Has suppressed immune system
- HIV carrier
- Infected by human papillomavirus
- In postmenopausal age (50s)
Symptoms of low grade squamous intraepithelial lesion
Women with LGSIL will not know about it unless a Pap smear test is performed because the abnormalities in the cervical squamous cells are really subtle and unable to cause major symptoms. However, symptoms will start to show when a significant part of the cervix has been affected. Those afflicted will complain about:
- Itchy and sore vaginal area
- Foul-smelling vaginal discharge
- Pain in the vaginal region
Low grade squamous intraepithelial lesions are already advancing and spreading to most parts of the cervix when symptoms occur. The affected woman may also notice some visible lumps that keep growing and eventually become ulcerated.
Diagnosis of low grade squamous intraepithelial lesion
LGSIL has no early symptoms, but it is still possible to detect the problem the earliest possible time via a Pap smear test. The simple Pap smear test will show changes in the appearance of squamous cells and the absence of uniformity among them. The cervical squamous cells could be conspicuously larger or appear different compared to nearby normal cells. The test is done by taking a small fluid sample from the cervix and examining the specimen under the microscope.
The doctor may investigate further to determine the extent of abnormalities and discount the chances of cancer by conducting additional tests, such as:
This procedure is done using a colposcope – a specialized magnifying instrument fitted with light to get a closer view of the cervix and vagina.
This test is done by removing a living cell or tissue to further confirm the diagnosis and estimate the progression and chances of recovery.
The doctor may choose to perform these two procedures at the same time.
Treatment of low grade squamous intraepithelial lesion
The treatment for low grade squamous intraepithelial lesion helps patients by treating and preventing the condition from aggravating. The disease usually has good prognosis at around 85% once detected and treated early. Addressing the problem early will also help prevent the abnormal squamous cells from developing into full blown cervical cancer. In some cases, low grade squamous intraepithelial lesion resolve on their own and treatment is not necessary. But if the tests conducted show that the problem is progressing and spreading, the doctor may conduct the following procedures as appropriate for each patient.
- Laser therapy
- LEEP or Loop Electrosurgical Excision Procedure
Low Grade Squamous Intraepithelial Lesion Pictures:-