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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: 123

  • Age: 49

  • Before application of acetic acid: A large nabothian cyst is present on the posterior lip. On closer inspection, the blood vessels appear prominent on the surface of the cyst.

  • Cervix before application of acetic acid:  
  • Nabothian cyst

    After application of acetic acid: A dense acetowhite area with sharp margins is present at the 12 o’clock position, with extension into the endocervical canal. The SCJ is not visible.

  • 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 lesion appears bright mustard yellow, with well-delineated margins.

  • Determined eligibility for ablative treatment:  

  • Histopathology: HSIL-CIN3

  • Remarks: Lesions extending into the endocervical canal should not be treated by ablation. The size of the lesion is much clearer after application of Lugol’s iodine.





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