Common Colposcopic Common Colposcopic findingsfindings

Prof. M. HEGABProf. M. HEGAB

DEFINITIONDEFINITION

Coloscopy is a procedure for examining Coloscopy is a procedure for examining

the vagina and cervix with the use of the vagina and cervix with the use of

lighted magnifying lenslighted magnifying lens..

Colposcopy enables the clinician to Colposcopy enables the clinician to

appreciate the physiology and pathology of appreciate the physiology and pathology of

the cervix in a fashion not approached by the cervix in a fashion not approached by

another method. another method.

The major value of colposcopy would be the The major value of colposcopy would be the

detection of Premalignant lesions of the detection of Premalignant lesions of the

cervix.cervix.

COLPOSCOPYCOLPOSCOPY

Normal-Cervix-by-Colposcopy

Colposcopy evaluates The changes in the terminal vascular network of

the cervix.

Cytology evaluates The morphologic changes in exfoliated cells.

The accuracy of the colposcopic diagnosis The accuracy of the colposcopic diagnosis depends on the colposcopist’s ability to depends on the colposcopist’s ability to evaluate evaluate the entire transformation zone, the entire transformation zone, identify and visualize the entire lesion, identify and visualize the entire lesion, biopsy the most suspicious areas and the biopsy the most suspicious areas and the

correlation with cervical cytologycorrelation with cervical cytology

In the diagram (upper), reserve cells in the transformation zone are continuous with the basal cells of the ectocervix (right) and may undergo columnar and squamous differentiation (metaplasia). Photomicrographs at bottom depict (from left to right) quiescent subcolumnar reserve cells, reserve cells undergoing columnar differentiation (second from left), reserve cells undergoing squamous metaplasia (second from right) and ectocervical squamous epithelium (right).

Squamocolumnar_junction.

Colposcopical Findings:Colposcopical Findings:

A.A. Normal colposcopical findings.Normal colposcopical findings.1.1. Original squamous epithelium.Original squamous epithelium.2.2. Columnar epithelium.Columnar epithelium.3.3. Transformation zone.Transformation zone.

BB- - Abnormal colposcopical findingsAbnormal colposcopical findings. . 1-1- A typical transformation zone A typical transformation zone

a- a- Aceto white epithelium.Aceto white epithelium.b- b- MosaicMosaicc- c- PunctuationPunctuationd- d- Atypical vascular pattern.Atypical vascular pattern.e- e- LeukoplakiaLeukoplakiaf- f- Suspect invasive carcinoma. Suspect invasive carcinoma.

CC.Unsatisfactory colposcopic finding. Squamocolumnar .Unsatisfactory colposcopic finding. Squamocolumnar

junction not visible.junction not visible.

DD.Miscellaneous colposcopic findings.Miscellaneous colposcopic findings..

1.1. Inflammatory changes.Inflammatory changes.

2.2. Erosion (ectopy).Erosion (ectopy).

3.3. Condyloma.Condyloma.

4.4. Papilloma. Papilloma.

Typical transformation zone

Normal cervix with squamocolumner junction

A, Colposcopic view of the cervix in a reproductive age woman. The portio epithelium (peripheral) merges with (at dotted boundary) and eventually replaces the endocervical columnar epithelium (red and grapelike) to form the transformation zone. The os is in the center. B, The postmenopausal cervix. The epithelial surface is smooth and completely covered by squamous epithelium. The squamocolumnar junction is not visible and is inside the endocervical canal.

Acetowhite change.

Leukoplakia.

Unsatisfactory colposcopy.

High-grade lesion with dense acetowhite epithelium on the posterior lip of the cervix.

aceto-white epithelium

Cervical cancer

cervical-cancer

cervical-erosion.

Vascular patternsVascular patterns

Thank youThank you