Loop electrosurgical excision procedure

Loop electrosurgical excision procedure, abbreviated LEEP, is a gynecologic procedure to remove tissue from the uterine cervix. It is used to diagnose, stage and treat cervical neoplasia.

Negative LEEP

Definition:

• LSIL or NILM, on a LEEP prompted by HSIL.

Prevalence:

• Relatively common ~ 25% of cases in one larger series.

Work-up

1. Review the biopsy that triggered the LEEP - check whether it is HSIL.
2. Cut levels (x3) on all blocks.
3. Flip all the blocks and cut levels (x3) on all the blocks.
4. Do a p16 immunostain on the most suspicious block, if the triggering diagnosis was cannot exclude HSIL, HSIL or SCC.
5. 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

• Cervical intraepithelial neoplasia.
• HSIL.