An area of abnormal cells that forms on the surface of certain organs, such as the cervix, vagina, vulva, anus, and esophagus. High-grade squamous intraepithelial lesions look somewhat to very abnormal when looked at under a microscope. They are usually caused by chronic infection with certain types of human papillomavirus (HPV) and are found when a Pap test or biopsy are done. If not treated, these abnormal cells may become cancer and spread to nearby normal tissue. A high-grade squamous intraepithelial lesion is sometimes called moderate or severe dysplasia. Also called HSIL.