IV. Unsatisfactory colposcopy

• SCJ not visible
• Severe inflammation or atrophy
• Cervix not visible

V. Miscellaneous findings

• Non-Acetowhite micropapillary surface
  Often associated with congenital normal development, inflammation, or chemical irritants


• Inflammation/vaginocervicitis
  Diffuse colposcopic pattern of hyperemia, characterized by alterations in capillaries
  

  Click on the image to enlarge. Diffuse red pattern in Candida cervicovaginitis. From Wright VC et al: Basic and advanced colposcopy: a practical handbook for diagnosis and treatment, ed 2, Canada, 1995, Biomedical Communications.

  
  

May even have punctation or mosaicism appearance, but differs from cervical intraepithelial neoplasia with respect to minimal increase in intercapillary distance, nonfocal nature, diffuse borders, frequent extension into vagina, and at least partial iodine uptake


Click on the image to enlarge. Diffuse red punctation and mosaic-like pattern in Candida cervicovaginitis. From Wright VC et al: Basic and advanced colposcopy: a practical handbook for diagnosis and treatment, ed 2, Komoka, Ont , Canada, 1995, Biomedical Communications.

Trichomonas may produce a punctation-like appearance in a patchy or geographic pattern


Click on the image to enlarge. Focal red punctation in acute Trichomonas cervicovaginitis. From Wright VC et al: Basic and advanced colposcopy : a practical handbook for diagnosis and treatment, ed 2, Canada, 1995, Biomedical Communications.

Responses such as yellow spots (lymphocyte collections), white spots (reverse punctation), and ulcerations (syphilis, herpes simplex virus) may occur


Click on the image to enlarge. White punctation in Candida cervicovaginitis. From Wright VC et al: Basic and advanced colposcopy: a practical handbook for diagnosis and treatment, ed 2, Canada, 1995, Biomedical Communications.





Differentiation between inflammation and the atypical TZ. From Wright, et al: Basic and Advanced Colposcopy: a practical handbook for diagnosis and treatment, ed 2, Canada, 1995, Biomedical Communications.

• Atrophy
  Thin, estrogen-deprived epithelium
  

  Click on the image to enlarge. Atrophic postmenopausal squamous epithelium. From Burghardt E et al: Text and atlas: colposcopy—cervical pathology, New York, 1991, Thieme.

  
  

• Condyloma
  Common morphologic manifestations of the human papilloma virus
  Lesions appear inside or outside the TZ
  

  Click on the image to enlarge. Cervical condylomata. From Giuntoli RL et al: Textbook and atlas: Atkinson's correlative atlas of colposcopy, cytology, and histopathology, Philadelphia, 1987, Lippincott-Raven.

  
  

• Others
  
  • Polyps
    

    Click on the image to enlarge. Multiple endocervical polyps arising from an atrophic cervix. From Burghardt E et al: Text and atlas: colposcopy—cervical pathology, New York, 1991, Thieme.

    
    

• Endometriosis
  

  Click on the image to enlarge. Bluish endometriotic deposit in posterior fornix. From Burghardt E et al: Text and atlas: colposcopy—cervical pathology, New York, 1991, Thieme.

  
  

• Adenocarcinoma
  

  Click on the image to enlarge. Endocervical adenocarcinoma. From Giuntoli RL et al: Textbook and atlas: Atkinson's correlative atlas of colposcopy, cytology, and histopathology, Philadelphia, 1987, Lippincott-Raven.

  
  

• Adenosis

Click on the image to enlarge. Vaginal adenosis–red spots related to residual glandular tissue. From Burghardt E et al: Text and atlas: colposcopy—cervical pathology, New York, 1991, Thieme.

• Postirradiation changes


• Reparative changes


• Wound healing
  

  Click on the image to enlarge. Cervix following conization; scarring and fine vasculature. From Burghardt E et al: Text and atlas: colposcopy—cervical pathology, New York, 1991, Thieme.

  
  

• Ulcers
  Denuded area of epithelium and stroma
  Associated with trauma, bacterial, viral, or neoplastic causes
  Biopsy should include a margin of epithelium
  

  Click on the image to enlarge. From Burghardt E et al: Text and atlas: colposcopy—cervical pathology , New York, 1991, Thieme.

  
  

Click here for a further description of the anatomy of the cervix.