Difference between revisions of "Loop electrosurgical excision procedure"
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'''Loop electrosurgical excision procedure''', abbreviated '''LEEP''', is a gynecologic procedure to remove tissue from the [[uterine cervix]].<ref>URL: [http://www.webmd.com/cancer/cervical-cancer/loop-electrosurgical-excision-procedure-leep-for-abnormal-cervical-cell-changes http://www.webmd.com/cancer/cervical-cancer/loop-electrosurgical-excision-procedure-leep-for-abnormal-cervical-cell-changes]. Accessed on: 13 August 2012.</ref> It is used to diagnose, stage and treat cervical neoplasia. | '''Loop electrosurgical excision procedure''', abbreviated '''LEEP''', is a gynecologic procedure to remove tissue from the [[uterine cervix]].<ref>URL: [http://www.webmd.com/cancer/cervical-cancer/loop-electrosurgical-excision-procedure-leep-for-abnormal-cervical-cell-changes http://www.webmd.com/cancer/cervical-cancer/loop-electrosurgical-excision-procedure-leep-for-abnormal-cervical-cell-changes]. Accessed on: 13 August 2012.</ref> It is used to diagnose, stage and treat cervical neoplasia. | ||
==Work-up | ==Negative LEEP== | ||
#Review the biopsy that triggered the LEEP. | Definition: | ||
*LSIL or NILM, on a LEEP prompted by HSIL.<ref name=pmid23020732/> | |||
Prevalence: | |||
*Relatively common ~ 25% of cases in one larger series.<ref name=pmid23020732>{{Cite journal | last1 = Witt | first1 = BL. | last2 = Factor | first2 = RE. | last3 = Jarboe | first3 = EA. | last4 = Layfield | first4 = LJ. | title = Negative loop electrosurgical cone biopsy finding following a biopsy diagnosis of high-grade squamous intraepithelial lesion: frequency and clinical significance. | journal = Arch Pathol Lab Med | volume = 136 | issue = 10 | pages = 1259-61 | month = Oct | year = 2012 | doi = 10.5858/arpa.2011-0494-OA | PMID = 23020732 }}</ref> | |||
===Work-up=== | |||
#Review the biopsy that triggered the LEEP - check whether it is HSIL. | |||
#Cut levels (x3) on all blocks. | #Cut levels (x3) on all blocks. | ||
#Flip all the blocks and cut levels (x3). | #Flip all the blocks and cut levels (x3) on all the blocks. | ||
#Do a p16 [[immunostain]] on the most suspicious block, if the triggering diagnosis was ''cannot exclude HSIL'', ''HSIL'' or ''SCC''. | #Do a p16 [[immunostain]] on the most suspicious block, if the triggering diagnosis was ''cannot exclude HSIL'', ''HSIL'' or ''SCC''. | ||
#Sign out the thing as negative - see below. | |||
==Sign out== | ==Sign out== | ||
Revision as of 04:56, 19 November 2013
Loop electrosurgical excision procedure, abbreviated LEEP, is a gynecologic procedure to remove tissue from the uterine cervix.[1] It is used to diagnose, stage and treat cervical neoplasia.
Negative LEEP
Definition:
- LSIL or NILM, on a LEEP prompted by HSIL.[2]
Prevalence:
- Relatively common ~ 25% of cases in one larger series.[2]
Work-up
- Review the biopsy that triggered the LEEP - check whether it is HSIL.
- Cut levels (x3) on all blocks.
- Flip all the blocks and cut levels (x3) on all the blocks.
- Do a p16 immunostain on the most suspicious block, if the triggering diagnosis was cannot exclude HSIL, HSIL or SCC.
- Sign out the thing as negative - see below.
Sign out
Negative LEEP
A. UTERINE CERVIX, LOOP ELECTROSURGICAL EXCISION PROCEDURE (LEEP): - ACUTE AND CHRONIC CERVICITIS. - BENIGN SQUAMOUS EPITHELIUM, METAPLASTIC SQUAMOUS EPITHELIUM, AND BENIGN ENDOCERVICAL GLANDS. - NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY, SEE COMMENT. B. UTERINE ENDOCERVIX, CURETTAGE: - ENDOCERVICAL MUCOSA AND STRIPPED ENDOCERVICAL EPITHELIUM WITHIN NORMAL LIMITS. - BENIGN SQUAMOUS EPITHELIUM. - NEGATIVE FOR DYSPLASIA. COMMENT: Levels were cut (x3) on all blocks. The blocks were then flipped and an additional set of levels (x3) were cut on all blocks. A p16 immunostain was done on A1. It does not demonstrate high-grade dysplasia. The previous pathology was partially reviewed, and I have no significant disagreement with the findings.
See also
References
- ↑ URL: http://www.webmd.com/cancer/cervical-cancer/loop-electrosurgical-excision-procedure-leep-for-abnormal-cervical-cell-changes. Accessed on: 13 August 2012.
- ↑ 2.0 2.1 Witt, BL.; Factor, RE.; Jarboe, EA.; Layfield, LJ. (Oct 2012). "Negative loop electrosurgical cone biopsy finding following a biopsy diagnosis of high-grade squamous intraepithelial lesion: frequency and clinical significance.". Arch Pathol Lab Med 136 (10): 1259-61. doi:10.5858/arpa.2011-0494-OA. PMID 23020732.