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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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VIA-negative cases                                                                            Click to return to the atlas
                                                                                                                         Click on the pictures to magnify and display the legends


  
  • Case: 16

  • Age: 31

  • Before application of acetic acid: The external os is covered by mucoid discharge.

  • Cervix before application of acetic acid:  

  • After application of acetic acid: Acetic acid dissolves the mucus, and the SCJ becomes clearly visible. The ectocervix is covered by pink mature squamous epithelium. No acetowhite area.

    After application of acetic acid (magnified view): Crypt openings are seen as tiny openings with a surrounding thin acetowhite border. The islands of columnar epithelium (skip areas) appear as small pockets through which the red columnar epithelium is visible. The features are indicative of metaplasia.

  • 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 cervix may not show any features of metaplasia (e.g. no crypt openings or nabothian cysts). An area of a few square millimetres surrounding the SCJ is considered as the transformation zone (TZ). Sometimes the TZ appears pale in colour compared with the mature squamous epithelium surrounding it.





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