specimen for DNA testing.
If conventional methods were used, repeat a second Pap. Perform
colposcopy only if high-risk HPV DNA is identified.
Colposcopy: indicated for evaluation of LSIL in patients age ≥25 and all
patients with ASC-H and HSIL. Colposcopy is a magnification of the cervix
(10–12x); it is aided by acetic acid, which makes the vascular patterns more
visible.
Satisfactory or adequate colposcopy is diagnosed if the entire T-zone is
visualized and no lesions disappear into the endocervical canal.
Unsatisfactory or inadequate colposcopy is diagnosed if the entire T-
zone cannot be fully visualized.
Endocervical curettage (ECC): All nonpregnant patients undergoing
colposcopy that shows metaplastic epithelium entering the endocervical canal
will undergo an ECC to rule out endocervical lesions.
Ectocervical biopsy: Lesions identified on the ectocervix by colposcopy
(e.g., mosaicism, punctation, white lesions, abnormal vessels) are biopsied
and sent for histology.
Compare Pap smear and biopsy: When the biopsy histology is complete, it
is compared with the level of Pap smear abnormality to ensure the level of
severity is comparable.
Cone biopsy: If the Pap smear is worse than the histology (suggesting the site
of abnormal Pap smear cells was not biopsied), then a cone biopsy is
performed. Other indications for conization of the cervix include abnormal
ECC histology, a lesion seen entering the endocervical canal, and a biopsy
showing microinvasive carcinoma of the cervix. Deep cone biopsies can
result in an incompetent cervix. Another risk of cone biopsy is cervical
stenosis.
kiana
(Kiana)
#1