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Atlas of Colposcopy: Principles and Practice

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High grade / CIN2 / CIN3
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  • Age: 50
  • HPV status: Positive


  • After normal saline

    After normal saline with green filter

    After acetic acid

    After acetic acid

    After acetic acid with green filter

    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: Not possible (Iodine uptake missing)



    Case Summary
    Provisional diagnosis: High-grade squamous intraepithelial lesion (HSIL) on a cervical polyp.
     
    Management: Removal of mucous polyp followed by LLETZ (type will depend on the visibility of the SCJ after removal of polyp).
     
    Histopathology: HSIL-CIN3.
     
    Comment: This is a rare case in which a high-grade lesion has developed only on the polyp. On removal of the polyp, no abnormality was seen on the cervix.


      
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