HPV-negative but biopsy says CIN 3 — has anyone had conflicting HPV/Pap/biopsy results or requested a pathology re-review?
I'm hoping to hear from anyone who has experienced something similar because I’m feeling pretty anxious about an upcoming LEEP.
In 2025, I had an abnormal Pap and tested positive for high-risk HPV. My colposcopy looked concerning for a high-grade lesion, but the biopsies ultimately came back as only CIN 1. Because of that, we decided to wait and repeat testing rather than treat it.
Fast forward to 2026: my high-risk HPV test is now negative, but my Pap was abnormal/high-grade again. Initially, I felt reassured by the negative HPV result and was told that it appeared my body had cleared the HPV infection.
I had another colposcopy, and this time one of the biopsies was diagnosed as HSIL/CIN 3. My other biopsy and ECC did not show atypia.
No p16 or Ki-67 staining was performed. I also noticed what appeared to be an error in the pathology report—the specimen was documented as 4 cm when apparently it should have been 0.4 cm (4 mm). I understand that this may simply be a transcription error and doesn't necessarily have anything to do with the interpretation of the tissue, but it made me less confident in the report.
I've also been reading about immature squamous metaplasia and other benign/reactive changes that can sometimes mimic high-grade changes under the microscope. I realize that doesn't mean my CIN 3 diagnosis is wrong, but between the negative high-risk HPV test and the error in the pathology report, I asked if another pathologist could review the slides before I undergo the LEEP.
My doctor feels strongly that this is CIN 3 because my Pap, colposcopy appearance, and biopsy all point toward a high-grade lesion and recommends that I proceed with the LEEP. My LEEP is scheduled for next week, and I currently plan to proceed. I just want to feel confident in the diagnosis before having an excisional procedure.
A major part of my anxiety is that I'm actively trying to become a mother. I know LEEP is commonly performed and many women go on to have completely normal pregnancies afterward, but I'm concerned about the potential effects of cervical excision on future pregnancy, especially when I've already been struggling to conceive.
I also feel a little uncomfortable because I worry that requesting a second pathology review came across as questioning my doctor. That wasn't my intention at all. I just want to be thorough before making a decision that could potentially affect a future pregnancy.
Has anyone experienced high-grade Pap/CIN 3 with a negative high-risk HPV test?
Has anyone had CIN 3 slides re-reviewed and received a different diagnosis, or had p16 staining added afterward?
And for anyone who requested a second pathology opinion before a LEEP, was your gynecologist supportive?
I'm not looking for Reddit to tell me whether or not to have the LEEP—I plan to follow medical guidance. I'm mostly interested in hearing from people who have dealt with conflicting HPV/Pap/biopsy results or sought a second pathology review before treatment.