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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: 21

  • Age: 30

  • Before application of acetic acid: The cervix is covered with copious mucoid discharge.

  • Cervix before application of acetic acid:  
  • Ectropion

    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:  
    • Acetowhite area:  

  • VIA category:  

  • 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.





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