Colposcopy and Treatment of Cervical Intraepithelial Neoplasia - RHO

More documents

Recommendations

Info

Colposcopic appearance of the normal cervix a a ↑ a squamous metaplastic epithelium usually does not stain with iodine or may partially stain if it is partially glycogenated (Figure 6.17). The vascular features, so easily seen with saline, may be difficult to observe after application of Lugol’s iodine solution. Cervical polyps do not stain with iodine, as they are usually covered with columnar or immature metaplastic epithelium (Figure 6.18). If the maturation of the metaplastic epithelium varies, one may observe various fields of no uptake or partial to full iodine uptake on the polyp. In postmenopausal women, the ectocervix may not stain fully with iodine, due to atrophy of the epithelium. FIGURE 6.15: Immature squamous metaplastic epithelium (narrow arrow) on the polyp with intervening areas of columnar epithelium (a), after application of 5% acetic acid. metaplastic) epithelium in women in the reproductive age group will take up the stain and become mahogany brown or black (Figure 6.16). This is helpful in distinguishing normal from abnormal areas in the transformation zone that have shown faint acetowhitening. The columnar epithelium does not stain with iodine (Figure 6.16). The immature Congenital transformation zone The congenital transformation zone stains white after application of acetic acid. In this condition, the metaplastic epithelium formed during the latter portion of fetal life, lying distal to the transformation zone formed after birth, is located far out on the ectocervix, some distance from the cervical os and, in some cases, may even extend onto the vagina. It is important to recognize this as a normal condition for which no treatment is necessary. With acetic acid, the congenital transformation zone will usually take on a mild acetowhite stain and the capillary vasculature may have a fine mosaic pattern Squamous epithelium Columnar epithelium Squamous epithelium Columnar epithelium has not taken up iodine FIGURE 6.16: Colour changes after application of Lugol's iodine 53
Chapter 6 a FIGURE 6.17: An area of no or partial iodine uptake in the immature squamous epithelium (a) (appearance after acetic acid application is shown in figure 6.13) FIGURE 6.18: After application of Lugol’s iodine solution, the endocervical polyp and the immature squamous metaplasia surrounding the os partially take up iodine (see Chapter 7). It does not take up iodine after application of Lugol’s iodine solution. If a biopsy is taken of the tissue to confirm the diagnosis, it is best to alert the pathologist of the colposcopic diagnosis. We emphasize that it is always necessary to provide the detailed colposcopic findings to the pathologist. 54
Page 1 and 2:
Colposcopy and Treatment of Cervica
Page 3 and 4:
INTERNATIONAL AGENCY FOR RESEARCH O
Page 5 and 6:
Published by the International Agen
Page 7 and 8:
Contents 11 Management that provide
Page 9 and 10:
Acknowledgements The authors gratef
Page 11 and 12:
Preface Health care providers have
Page 13 and 14: Chapter 1 An introduction to the an
Page 15 and 16: An introduction to the anatomy of t
Page 25 and 26: Chapter 2 An introduction to cervic
Page 27 and 28: An introduction to cervical intraep
Page 33 and 34: Chapter 3 An introduction to invasi
Page 35 and 36: An introduction to invasive cancer
Page 41 and 42: Chapter 4 Table 4.1: Indications fo
Page 43 and 44: Chapter 4 FIGURE 4.2: Colposcope wi
Page 45 and 46: Chapter 4 FIGURE 4.6: Endocervical
Page 47 and 48: Chapter 4 Table 4.2: Preneoplastic
Page 49 and 50: Chapter 5 between the two ocular le
Page 51 and 52: Chapter 5 Obtain specimens for labo
Page 53 and 54: Chapter 5 FIGURE 5.2: Biopsy techni
Page 55 and 56: Chapter 5 tissue tends to mimic inv
Page 57 and 58: Chapter 6 invasive carcinoma. Even
Page 59 and 60: Chapter 6 ages (Figures 1.7d, 1.7e,
Page 61 and 62: Chapter 6 FIGURE 6.7: The colour ch
Page 63: Chapter 6 Crypt openings Immature s
Page 67 and 68: Chapter 7 The colposcopic diagnosis
Page 69 and 70: Chapter 7 appears as individual sma
Page 71 and 72: Chapter 7 acid stain is correlated
Page 73 and 74: Chapter 7 FIGURE 7.15: Moderately d
Page 75 and 76: Chapter 7 FIGURE 7.23: A dense acet
Page 77 and 78: Chapter 7 FIGURE 7.30: Mustard yell
Page 79 and 80: Chapter 7 We recommend that the stu
Page 81 and 82: 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 and 134:
Appendix Monsel’s paste Ingredien
Page 135 and 136:
Appendix 5 The modified Reid colpos
Page 137 and 138:
Index Acetowhitening . . . . . . .
show all

Colposcopy and Treatment of Cervical Intraepithelial Neoplasia - RHO

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?