Learn about your diagnosis

Cervix – Low grade squamous intraepithelial lesion (LSIL)

This article will help you read and understand your pathology report for low grade squamous intraepithelial lesion (LSIL) of the cervix.

by Jason Wasserman, MD PhD FRCPC, updated on June 4, 2020

Quick facts:
  • Low grade squamous intraepithelial lesion (LSIL) is a non-cancerous condition that develops in the cervix.
  • LSIL is caused by a virus called human papillomavirus (HPV) which infects cells on the surface of the cervix.
  • LSIL can turn into a cancer over time but the risk is very low.

In this article you will learn about:

  • The normal cervix
  • What is low grade squamous intraepithelial lesion?
  • What causes low grade squamous intraepithelial lesion?
  • How do pathologists make this diagnosis?
The normal cervix

The cervix is part of the female genital tract. It is found at the bottom of the uterus where it forms an opening and a canal into the endometrial cavity of the uterus.

The outer surface of the cervix is lined by two types of cells that form a barrier called the epithelium. The first part of the cervix is called the exocervix and it is lined by squamous cells. The second part of the cervix is called the endocervical canal and it is lined by rectangular shaped cells which connect together to make small structures called glands.

The tissue below the epithelium is called the stroma and is made up of connective tissue and blood vessels.

What is low grade squamous intraepithelial lesion (LSIL)?

Low grade squamous intraepithelial lesion (LSIL) is a non-cancerous disease that develops from the squamous cells on the surface of the cervix.

Although LSIL is considered non-cancerous disease, there is a very small risk that it will turn into a cancer over time. However, for most patients with LSIL, the immune system will remove the infected cells and the cervix will return to normal.

The abnormal cells in LSIL are unable to spread into the tissues outside of the cervix or to other parts of the body such as lymph nodes.

What causes low grade squamous intraepithelial lesion?

LSIL is caused by a virus called human papillomavirus (HPV) that infects the squamous cells. Once inside the cell, HPV changes the cell and prevents it from developing normally. Pathologists call this change dysplasia.

The specific HPV virus associated with LSIL is typically a low risk type of HPV.  Cells infected with low risk HPV are much larger than normal squamous cells and are called koilocytes.

A similar condition with the same name (LSIL) can develop in the vagina or vulva.

How do pathologists make this diagnosis?

The diagnosis of LSIL is usually made after a small sample of tissue is removed during a Pap test.  A larger tissue sample may later be removed in a procedure called a biopsy to look for a related but more serious condition called high grade intraepithelial lesion (HSIL) or squamous cell carcinoma.

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