Atlas of Colposcopy: Principles and Practice

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Inflammation and cervicitis / Inflammation
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Age: 31
HPV status: Positive

Before speculum examination

Speculum examination

After normal saline

After normal saline

After normal saline

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 transparent Thin, milky Distinct, stearin
Margins Nil or diffuse Sharp but irregular, jagged, satellites Sharp and even, difference in level
Vessels Fine, regular Absent Coarse or atypical vessels
Lesion size < 5 mm 5-15 mm or 2 quadrants >15 mm, 3-4 quadrants, or endocervically undefined
Iodine uptake Brown Faintly or patchy yellow Distinctly yellow
Final Swede score: Not done (Inadequate colposcopy)

Case Summary
Provisional diagnosis: Inadequate colposcopy due to severe vaginal infection.

Management: Repeat colposcopy after a course of antibiotics and anti-inflammatory drugs.

Histopathology: Not done.

Comment: Due to severe infection, epithelium was soft and oedematous and started peeling off. Cervix could not be exposed due to excessive bleeding and pain to the patient.

Swede score	0	1	2
Aceto uptake	Nil or transparent	Thin, milky	Distinct, stearin
Margins	Nil or diffuse	Sharp but irregular, jagged, satellites	Sharp and even, difference in level
Vessels	Fine, regular	Absent	Coarse or atypical vessels
Lesion size	< 5 mm	5-15 mm or 2 quadrants	>15 mm, 3-4 quadrants, or endocervically undefined
Iodine uptake	Brown	Faintly or patchy yellow	Distinctly yellow

Provisional diagnosis:	Inadequate colposcopy due to severe vaginal infection.

Management:	Repeat colposcopy after a course of antibiotics and anti-inflammatory drugs.

Histopathology:	Not done.

Comment:	Due to severe infection, epithelium was soft and oedematous and started peeling off. Cervix could not be exposed due to excessive bleeding and pain to the patient.