Colposcopy Examination

Dwiana Ocviyanti• Department of Obstetrics and Gynecology Faculty of

Medicine University of Indonesia• National Clinical Training Network of Reproductive

Health/NCTN-RH

Colposcopy

• An important tool for clinicians to diagnose precancerous and cancer lesion of the cervix

• Histopathology is the gold standard for the diagnosis of precancerous and cancer lesion of the cervix

• The purpose of colposcopy is to help the clinicians to do the biopsy at the most proper site on the cervix.

COLPOSCOPY

Tools preparation

A satisfactory colposcopy

• One where the squamocolumnar junction and the full extent of abnormal epithelium are visible

• An exam is unsatisfactory when the extent of lesion is not seen

• This occurs when the lesion extends into the endocervix or is obscured by inflammation or atrophy, squamocolumnar junction is not visible or there is severe inflammation or severe atrophy or cervix is not visible.

Normal colposcopic findings

• original squamous epithelium

• columnar epithelium

• normal transformation zone

Transformation zone

NSCJ

Old SCJ

Abnormal colposcopic findings

• acetowhite epithelium

• Punctuation

• Mosaic

• Leukoplakia

• iodine negative

• atypical vessels

Low-grade dysplasia

Miscellaneous findings

• Non-acetowhite micropapillary surface

• Exophytic condyloma

• Inflammation

• Atrophy

• Ulcer

Abnormal Colposcopy of the Cervix

• Patterns of the abnormal ectocervical epithelium containing precancer lesion are described as acetowhite, mosaic, and punctated

• Foci of invasive carcinoma may be detected by atypical blood vessel patterns

• Early invasion may have the above stated abnormalities in a larger lesion with ulceration, increased vascularity, or the presence of other epithelial types.