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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: 110

  • Age: 40

  • Before application of acetic acid: The cervix appears normal. Only the ectocervix is visible.

  • Cervix before application of acetic acid:  

  • After application of acetic acid: Acetowhite areas with sharp angular geographical margins are present on both the anterior and posterior lips. The acetowhite area close to the external os at the 10Ė12 oíclock position is denser. The lesion extends into the endocervical canal. A few satellite lesions are seen.

  • 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 Lugolís iodine: The lesion shows patchy iodine non-uptake areas.

  • Determined eligibility for ablative treatment:  

  • Histopathology: Anterior lip: HSIL-CIN2; Posterior lip: LSIL-CIN1

  • Remarks: The dense acetowhite area is limited to the anterior lip close to the external os. The other thin acetowhite areas and satellite lesions suggest the presence of low-grade abnormalities and HPV infection. High-grade lesions can coexist with low-grade lesions. When lesions of different severity coexist, the features of the most severe lesion should always be documented.





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