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Atlas of Colposcopy: Principles and Practice

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High grade / CIN2 / CIN3  Go back to the list



  

  • Age: 52
  • HPV status: Positive


  • After normal saline

    After acetic acid

    After acetic acid

    After acetic acid

    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: Not possible (Iodine uptake missing)



    Case Summary:

    Provisional diagnosis: Type 3 transformation zone; high-grade squamous intraepithelial lesion (HSIL); cervical endometriosis.
      
    Management: LLETZ (type 3 excision).
      
    Histopathology: HSIL-CIN3.
    Comment: Cervical endometriosis is a rare condition. In this case, the patient did not have any symptoms, and the dark bluish nodule was detected during colposcopy. The nodule was excised during LLETZ. There was no evidence of pelvic endometriosis.


      
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