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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: 22

  • Age: 38

  • Before application of acetic acid: The columnar epithelium is visible as a red patch around the external os.

  • Cervix before application of acetic acid:  
  • Ectropion

    After application of acetic acid: Diffuse streaks of acetowhitening on the columnar epithelium suggest metaplasia. No acetowhite area on the squamous epithelium.

  • Cervix after application of acetic acid:
    • Squamocolumnar junction visibility:  
    • Squamocolumnar junction location:  
    • Acetowhite area:  

  • VIA category:  

  • Determined eligibility for ablative treatment (if HPV-positive):  

  • Histopathology: Not done

  • Remarks: The indistinct acetowhite areas on the ectropion are due to metaplasia starting at the tips of the villi of the columnar epithelium. The villi flatten and coalesce to form thin sheets of pinkish white metaplastic epithelium. VIA is negative because there is no definite opaque white patch.





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