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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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  • Case: 134

  • Age: 41

  • Before application of acetic acid: The ectocervix is mostly covered by mature squamous epithelium.

  • Cervix before application of acetic acid:  

  • After application of acetic acid: A large dense acetowhite area with sharp margins is present on the posterior lip, with extension into the endocervical canal. The red area on the anterior lip is due to peeling off of epithelium, resulting in erosion.

  • Cervix after application of acetic acid:
    • Squamocolumnar junction visibility:  
    • Squamocolumnar junction location:  
    • Acetowhite area:  
      • If present, description of acetowhite area:
        • Colour:  
        • Margin:  
        • Surface:  
        • Location:  
        • Size:  

  • VIA category:  

  • After application of Lugol’s iodine: The acetowhite area does not stain with Lugol’s iodine and appears bright mustard yellow, sharply demarcated from the surrounding normal epithelium, which appears brown.

  • Determined eligibility for ablative treatment:  

  • Histopathology: HSIL-CIN3

  • Remarks: On VIA, an erosion located close to the external os may lead to a false interpretation of visualization of the SCJ. The lesion on the anterior lip is much more extensive than it appears.





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