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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: 115

  • Age: 44

  • Before application of acetic acid: The cervix appears normal.

  • Cervix before application of acetic acid:  

  • After application of acetic acid: A large dense acetowhite area is seen occupying all four quadrants of the cervix. The lesion extends into the endocervical canal. Small bleeding points are seen on the lesion.

    After application of acetic acid: The lesion has raised margins on the posterior lip. Areas of erosion are present close to the external os at the 6 o’clock position.

  • 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 distinct bright mustard yellow colour of the lesion contrasts with the brown normal epithelium.

  • Determined eligibility for ablative treatment:  

  • Histopathology: Microinvasive carcinoma

  • Remarks: Such a large lesion with raised margins and bleeding from surface erosion is also suspicious of cancer. In any case, such a lesion should not be treated by ablation.





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