Low-Grade Cytology Referral
Patient Background:
27 years old (smoker: unknown)
Referred with a Borderline/hrHPV test result
Colposcopic impression was that of Low-Grade changes
DYSISmap highlighted focal suspicious area
Colposcopically directed biopsy (#1): Normal/HPV changes
DYSISmap directed biopsy (#2): CIN2
The subsequent conization (LLETZ) revealed CIN1; apparently the damage had been removed by the punch biopsy process
The colposcopist selected to biopsy at 12 o’clock (white circle), but after seeing the DYSISmap, also identied 6 o’clock (yellow circle) as an important biopsy site. The biopsy 1 returned histology showing HPV changes only; whereas the biopsy location 2, indicated by the DYSISmap was CIN2. According to the UK guidelines for managing women at colposcopy, with only biopsy 1 as a reference, this HPV-positive patient would have been released to 3-yearly routine screening creating a risk of disease progression.