title: The utility of 'low-grade intraepithelial lesion, cannot exclude high grade' diagnosis: a single institution's experience.
abstract: OBJECTIVE
  Squamous intraepithelial lesions (SILs) are classified as low-grade SIL (LGSIL) and high-grade SIL (HGSIL). 'LGSIL cannot exclude high grade' (LGSIL-H) interpretive category has been used in cases where findings exceed criteria for LGSIL, but do not fulfill the criteria for HGSIL. This study analyzed follow-up histology of LGSIL-H cases and compared the follow-up results of LGSIL-H with LGSIL to determine the utility of LGSIL-H category using a single institution's experience.
  
  
  METHODS
  Pap smears with LGSIL-H interpretation from 2005 to 2008 were retrieved. Histological follow-up results for LGSIL-H cases were analyzed and compared to the follow-up results of LGSIL cases.
  
  
  RESULTS
  Cases with LGSIL-H interpretation (311) comprised 0.18% of all cases (170,307). Follow-up was available for 144 patients and 13.2% had benign findings, 51.4% had cervical intraepithelial neoplasia (CIN) 1, and 35.4% had CIN 2 or higher. In comparison, of 425 patients with LGSIL, 22.6% had benign findings, 71% had CIN 1 and 6.4% had CIN 2 or higher.
  
  
  CONCLUSIONS
  A significantly greater number of patients with LGSIL-H interpretation had a CIN 2 or higher lesion on follow-up compared to patients with LGSIL. This suggests LGSIL-H may be a useful diagnostic category.
authors: Department of Pathology, New York University, School of Medicine, New York, NY, USA.
authors: Alexander
authors: A
authors: Finkelstein
authors: Ewa B
authors: EB
authors: Bajor-Dattilo
authors: Michael C
authors: MC
authors: Yang
authors: Oliver
authors: O
authors: Szeto
authors: Fang
authors: F
authors: Zhou
authors: Paul
authors: P
authors: Elgert
authors: Kasturi
authors: K
authors: Das
mesh_terms: D005260:Female; D006801:Humans; D060787:Neoplasm Grading; D065006:Papanicolaou Test; D002583:Uterine Cervical Neoplasms / Q000145:classification* / Q000473:pathology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000145:classification* / Q000473:pathology*