Atlas of Colposcopy: Principles and Practice / Activity 6

Case



Miscellaneous / Congenital transformation zone
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  • Age: 31
  • HPV status: Negative


    • Speculum examination

    After normal saline with green filter

    After acetic acid

    After acetic acid with green filter

    After Lugol’s iodine

    Colposcopy report (2011 IFCPC nomenclature):
    / Post-treatment consequence / Endometriosis

    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: 5



    Case Summary
    Provisional diagnosis: Type 1 transformation zone; congenital transformation zone.
    Management: Punch biopsy from the lesion (both the anterior and the posterior lip).
    Histopathology: Normal.
    Comment: The congenital transformation zone may mimic low-grade lesions.