Colposcopy and Treatment of Cervical Intraepithelial Neoplasia - RHO

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Appendix 4 Colposcopic terminology Normal colposcopic findings Original squamous epithelium Columnar epithelium Normal transformation zone Abnormal colposcopic findings Within the transformation zone Acetowhite epithelium Flat Micropapillary or microconvoluted Punctation* Mosaic* Leukoplakia* Iodine-negative epithelium Atypical vessels Outside the transformation zone, e.g., ectocervix, vagina Acetowhite epithelium* Flat Micropapillary or microconvoluted Punctation* Mosaic* Leukoplakia* Iodine-negative epithelium Atypical vessels Colposcopically suspect invasive carcinoma Unsatisfactory colposcopy Squamocolumnar junction not visible Severe inflammation or severe atrophy Cervix not visible Miscellaneous findings Nonacetowhite micropapillary surface Exophytic condyloma lnflammation Atrophy Ulcer Other * Indicates minor or major change. Minor changes are acetowhite epithelium, fine mosaic, fine punctation, and thin leukoplakia. Major changes are dense acetowhite epithelium, coarse mosaic, coarse punctation, thick leukoplakia, atypical vessels, and erosion. Ref: Stafl and Wilbanks (1991) 127
Appendix 5 The modified Reid colposcopic index (RCI)* The modified Reid colposcopic index (RCI)* Colposcopic signs Zero point One point Two points Colour Low-intensity acetowhitening (not Intermediate shade Dull, opaque, completely opaque); indistinct - grey/white colour oyster white; grey acetowhitening; transparent or and shiny surface translucent acetowhitening (most lesions should Acetowhitening beyond the margin of be scored in this the transformation zone category) Pure snow-white colour with intense surface shine (rare) Lesion margin and surface Microcondylomatous or micropapillary contour 1 Regular-shaped, symmetrical lesions Rolled, peeling edges 2 configuration Flat lesions with indistinct margins with smooth, Internal Feathered or finely scalloped margins Angular, jagged lesions 3 straight outlines demarcations between areas of Satellite lesions beyond the margin of differing the transformation zone colposcopic appearance—a central area of high-grade change and peripheral area of low-grade change Vessels Fine/uniform-calibre vessels 4 - closely Absent vessels Well defined coarse and uniformly placed punctation or Poorly formed patterns of fine mosaic, sharply punctation and/or mosaic demarcated 5 – and Vessels beyond the margin of the randomly and transformation zone widely placed Fine vessels within microcondylomatous or micropapillary lesions 6 128
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Colposcopy and Treatment of Cervica
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INTERNATIONAL AGENCY FOR RESEARCH O
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Published by the International Agen
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Contents 11 Management that provide
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Acknowledgements The authors gratef
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Preface Health care providers have
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Chapter 1 An introduction to the an
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An introduction to the anatomy of t
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Chapter 2 An introduction to cervic
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An introduction to cervical intraep
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Chapter 3 An introduction to invasi
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An introduction to invasive cancer
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Chapter 4 Table 4.1: Indications fo
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Chapter 4 FIGURE 4.2: Colposcope wi
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Chapter 4 FIGURE 4.6: Endocervical
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Chapter 4 Table 4.2: Preneoplastic
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Chapter 5 between the two ocular le
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Chapter 5 Obtain specimens for labo
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Chapter 5 FIGURE 5.2: Biopsy techni
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Chapter 5 tissue tends to mimic inv
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Chapter 6 invasive carcinoma. Even
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Chapter 6 ages (Figures 1.7d, 1.7e,
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Chapter 6 FIGURE 6.7: The colour ch
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Chapter 6 Crypt openings Immature s
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Chapter 6 a FIGURE 6.17: An area of
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Chapter 7 The colposcopic diagnosis
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Chapter 7 appears as individual sma
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Chapter 7 acid stain is correlated
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Chapter 7 FIGURE 7.15: Moderately d
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Chapter 7 FIGURE 7.23: A dense acet
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Chapter 7 FIGURE 7.30: Mustard yell
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Chapter 7 We recommend that the stu
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Chapter 8 highlights this responsib
Page 83 and 84: Chapter 8 Appearance before applica
Page 85 and 86: Chapter 8 diagnosis of AIS and aden
Page 87 and 88: Chapter 8 a ↑ FIGURE 8.10: Adenoc
Page 89 and 90: Chapter 9 Inflammatory lesions of t
Page 91 and 92: Inflammatory lesions of the uterine
Page 93 and 94: Inflammatory lesions of the uterine
Page 95 and 96: Chapter 10 Table 10.1: Common sourc
Page 97 and 98: Chapter 10 Table 10.2 (cont.): A su
Page 99 and 100: Chapter 11 FIGURE 11.1: Flow chart
Page 101 and 102: Chapter 11 treatment policies for p
Page 103 and 104: Chapter 11 Vaginal delivery can be
Page 105 and 106: Chapter 12 involvement increases wi
Page 107 and 108: Chapter 12 Table 12.1: Eligibility
Page 109 and 110: Chapter 12 a b c d e f FIGURE 12.6:
Page 111 and 112: Chapter 12 during the follow-up in
Page 113 and 114: Chapter 13 (2) (1) FIGURE 13.2: Ele
Page 115 and 116: Chapter 13 (1) (2) (3) (4) (5) (8)
Page 117 and 118: Chapter 13 Once the specimen has be
Page 119 and 120: Chapter 13 in the endocervical cana
Page 121 and 122: Chapter 14 Decontamination, cleanin
Page 123 and 124: Decontamination, cleaning, high-lev
Page 125 and 126: References Herrero, R. (1997) Preva
Page 127 and 128: Further reading Suggestions on furt
Page 129 and 130: Appendix Leukoplakia Condylom
Page 131 and 132: Appendix regardless of your pregnan
Page 133: Appendix Monsel’s paste Ingredien
Page 137 and 138: Index Acetowhitening . . . . . . .
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Colposcopy and Treatment of Cervical Intraepithelial Neoplasia - RHO

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