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Related Experiment Videos

Large loop excision of the transformation zone (LLETZ): a pathologic evaluation

M J Messing1, L Otken, L A King

  • 1Department of Obstetrics and Gynecology, Medical College of Georgia, Augusta 30912-3335.

Gynecologic Oncology
|February 1, 1994
PubMed
Summary

Large loop excision of the transformation zone (LLETZ) cone biopsies often yield suboptimal specimens due to thermal artifact. Improved handling and indications are crucial for accurate histologic evaluation of cervical biopsies.

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Area of Science:

  • Gynecologic Pathology
  • Cervical Pathology
  • Surgical Pathology

Background:

  • Large loop excision of the transformation zone (LLETZ) is a common procedure for diagnosing cervical abnormalities.
  • Specimen quality is critical for accurate histologic diagnosis following colposcopic biopsies.

Purpose of the Study:

  • To evaluate the quality of LLETZ cone biopsy specimens.
  • To identify factors affecting specimen adequacy and histologic evaluation.

Main Methods:

  • Retrospective review of 46 LLETZ cone biopsies performed between January 1991 and December 1991.
  • Pathologic assessment of specimen orientation, thermal artifact, margins, diagnosis, and adequacy.
  • Grading of thermal artifact and evaluation of transformation zone representation.

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Main Results:

  • Thermal artifact was a significant issue, graded moderate to severe in 30 cases.
  • Positive margins were found in 17 cases, and 8 were nonevaluable.
  • Only 13 specimens were comparable in quality to cold-knife cone biopsies.
  • Thermal artifact precluded accurate evaluation for microinvasion in three cases.

Conclusions:

  • Thermal artifact significantly compromises histologic evaluation of LLETZ specimens.
  • Inadequate specimen representation and orientation are common issues.
  • Improved understanding of LLETZ indications and enhanced specimen handling by practitioners and pathologists are necessary.