LGSIL and HGSIL are designations of abnormal pap smears. They stand for Low (or High) Grade Squmous Intraepithelial Lesion and are often referred to as “low grade pap” or “high grade pap”. Both of these types of pap smears will require a coplposcopy to determine why the pap smear is abnormal. These pap smears suggest that there is cervical dysplasia present. Cervical dysplasia is a precancerous change of the cells of the cervix that is easily treatable.

LGSIL pap smears are often false positives meaning there may be nothing wrong with the cervix. The most common finding with an LGSIL pap smear is CIN 1 (mild dysplasia) but a higher grade dysplasia can still be present. Colposcopy is necessary if a LGSIL pap smear is obtained. Colposcopy is a procedure in which the cervix is viewed with a microscope and biopsies are taken. If a significant dysplasia is found LEEP cone biopsy may be needed.

HGSIL pap smears almost always mean that dysplasia is present. In fact they are so indicative of dysplasia that if dysplasia is not found by the colposcopy, we assume that the lesion was missed. Colposcopy is necessary to determine the degree of dysplasia and to rule out the very small chance of cervical cancer. Depending on the degree of abnormality, LEEP is usually needed to cure the dysplasia.

Both HGSIL and LGSIL pap smears require colposcopy to diagnose the exact abnormality present. With LGSIL it is common to not need any treatment after the colposcopy. With HGSIL a LEEP cone biopsy is usually needed after the colposcopy diagnosis the problem.