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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: 141

  • Age: 36

  • Before application of acetic acid: The central red patch is columnar epithelium.

  • Cervix before application of acetic acid:  

  • After application of acetic acid: A thin acetowhite area with well-defined margins is seen on the anterior lip, attached to the SCJ and extending towards the vaginal fornix.

  • 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. The margins of the lesion are sharply delineated by the colour contrast. The typical oblong shape and vaginal extension of the lesion are diagnostic of the congenital transformation zone (CTZ).

  • Determined eligibility for ablative treatment:  

  • Histopathology: Normal

  • Remarks: The thin oblong (lozenge-shaped) acetowhite area with extension to the vaginal fornices is indicative of the congenital transformation zone (CTZ). Although it is a normal condition, colposcopy and/or cervical biopsies are needed to confirm the diagnosis.





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