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Atlas of Colposcopy: Principles and Practice

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Normal / Atrophy  Go back to the list



  

  • Age: 60
  • HPV status: Negative


  • Speculum examination

    After normal saline

    After acetic acid

    After acetic acid with green filter

    After Lugol’s iodine

    Colposcopy report (2011 IFCPC nomenclature):


    General assessment
  • Adequacy:
  • Squamocolumnar junction visibility:
  • Transformation zone:

  • Normal colposcopic findings
  • Original squamous epithelium:
  • Columnar epithelium:
  • Metaplastic squamous epithelium:
  • Deciduosis in pregnancy:

  • Abnormal colposcopic findings
    General principles
    Position and size
  • Location of the lesion:
  • Location of the lesion by clock position:
  • No. of quadrants:
  • % of cervix:

  • Grade 1 (minor)

    Grade 2 (major)

    Non-specific

    Suspicious for invasion

    Miscellaneous finding



    Swede score:

    Swede score
    0
    1
    2
    Aceto uptake
    Nil or transparentThin, milkyDistinct, stearin
    Margins
    Nil or diffuseSharp but irregular, jagged, satellitesSharp and even, difference in level
    Vessels
    Fine, regularAbsentCoarse or atypical vessels
    Lesion size
    < 5 mm5-15 mm or 2 quadrants>15 mm, 3-4 quadrants, or endocervically undefined
    Iodine uptake
    BrownFaintly or patchy yellowDistinctly yellow

    Final Swede score: 0



    Case Summary:

    Provisional diagnosis: Type 3 transformation zone; normal cervix with atrophic change.
      
    Management: No further screening is required.
      
    Histopathology: Not done.
    Comment: Blood vessels can have confusing patterns. The vessels seen over the anterior lip of the cervix are difficult to distinguish from atypical vessels. However, the absence of any acetowhite area helps to clinch the diagnosis.


      
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