Review Question - QID 210502

A 39-year-old woman presents to her gynecologist for her annual exam. She missed her "yearly exams" over the past 5 years because she was "too busy with work and family." She feels well and has no complaints. Her menses are regular, occurring every 29 days and lasting approximately 3 days. Menarche was at age 10. Her past medical history is notable for rheumatoid arthritis. She takes methotrexate. She has a 15-pack-year smoking history and drinks socially. She is married and has 2 children. She and her husband use condoms for protection. Her last Pap smear was 5 years ago and was normal. Her temperature is 98.8°F (37.1°C), blood pressure is 120/69 mmHg, pulse is 88/min, and respirations are 17/min. Pelvic examination demonstrates a normal appearing vagina with no adnexal or cervical motion tenderness. A Pap smear is performed, and a high-grade squamous intraepithelial lesion is identified. A cone biopsy is subsequently performed, and results are shown in Figure A. This patient most likely has which of the following conditions?