Click on the pictures to magnify and display the legends
Before application of acetic acid: The cervix is covered with copious mucoid discharge.
Cervix before application of acetic acid:
After application of acetic acid: Large ectropion present. The SCJ is fully visible.
After application of acetic acid (magnified view): The papillary projections (villi) of columar epithelium is prominent. Some of the villi show flattening with acetowhite changes at the tips suggesting metaplasia.
Cervix after application of acetic acid:
Squamocolumnar junction visibility:
Squamocolumnar junction location:
Determined eligibility for ablative treatment (if HPV-positive):
Histopathology: Not done
Remarks: The magnified view is to show the papillary projections (villi) that give the columnar epithelium a granular, velvet-like appearance. The transformation zone (TZ) has just started forming, with metaplastic change at the periphery of the ectropion. Such a cervix with a very large ectropion is better treated by thermal ablation (if the woman is HPV-positive), because the cryotherapy probe will not be able to cover the TZ beyond the large ectropion.