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Atlas of visual inspection of the cervix with acetic acid for screening, triage, and assessment for treatment

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Cervical epithelium – Squamocolumnar junction (SCJ)

  

The pink smooth squamous epithelium meets the red granular columnar epithelium at the squamocolumnar junction (SCJ), which is a very important landmark to identify on the cervix.

Naked-eye appearance of the SCJ
The SCJ is usually seen around the external os of the cervix as a sharp line of demarcation between the pink squamous epithelium and the red columnar epithelium.





The distinction between the squamous epithelium and the columnar epithelium becomes even more prominent after application of acetic acid to the cervix, making the SCJ easily visible.




Microscopic features of the SCJ
The SCJ appears as an abrupt junction between the multilayered stratified squamous epithelium of the ectocervix and the single-layered columnar epithelium of the endocervix.






  • The location of the SCJ in relation to the external os of the cervix varies depending on factors such as age, hormonal status, birth trauma, and certain physiological conditions, such as pregnancy.
  • Identification of the SCJ is extremely important, because almost all cervical precancers originate from this line.




































  


Click on the pictures to magnify and display the legends
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