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Atlas of colposcopy – principles and practice

Low grade / CIN1  Go back to the list


  • Age: 38
  • HPV status: Positive

  • 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)


    Suspicious for invasion

    Miscellaneous finding

    Swede score:

    Swede score
    Aceto uptake
    Nil or transparentThin, milkyDistinct, stearin
    Nil or diffuseSharp but irregular, jagged, satellitesSharp and even, difference in level
    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: 6

    Case Summary:

    Provisional diagnosis: Type 1 transformation zone; low-grade squamous intraepithelial lesion (LSIL) with SPI.
    Management: Punch biopsy should be directed from the lesion at the 8 o’clock position, because that is most dense and is adjacent to the erosion.
    Histopathology: LSIL-CIN1.
    Comment: The low-grade lesion probably extended over the area of erosion. It is also possible that the eroded area had a higher-grade lesion. Careful follow-up is necessary for this woman by repeat colposcopy after 1 year.

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