Case |
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After normal saline |
After acetic acid |
After acetic acid with green filter |
After acetic acid |
Visualization of the SCJ |
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Nil or transparent | Thin, milky | Distinct, stearin | |
Nil or diffuse | Sharp but irregular, jagged, satellites | Sharp and even, difference in level | |
Fine, regular | Absent | Coarse or atypical vessels | |
< 5 mm | 5-15 mm or 2 quadrants | >15 mm, 3-4 quadrants, or endocervically undefined | |
Brown | Faintly or patchy yellow | Distinctly yellow |
Provisional diagnosis: | Type 3 transformation zone; suspicion of squamous cell carcinoma. |
Management: | Multiple punch biopsies. |
Histopathology: | Squamous cell carcinoma. |
Comment: | Atypical vessels are better visible on acetowhite areas after 2–3 minutes of acetic acid application. A dense acetowhite area should again be evaluated with the green filter before applying Lugol’s iodine. |
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