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Differential
Diagnosis of Colposcopic Lesions
Various findings are shown below. Click here
to see a detailed description of the New Colposcopic Terminology.
Squamous metaplasia
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Click to enlarge. Metaplasia, incomplete transformation, and
gland openings. From Burghardt E et al: Text and atlas: colposcopy—cervical
pathology, New York, 1991, Thieme.
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Click to enlarge. Transformation on anterior lip. From Burghardt
E et al: Text and atlas: colposcopy—cervical pathology,
New York, 1991, Thieme.
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Leukoplakia
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Click to enlarge. Ground of leukoplakia. Where keratin layer
is peeled off, punctation appears. From Burghardt E et al: Text
and atlas: colposcopy—cervical pathology, New York, 1991,
Thieme.
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Click to enlarge. Pronounced leukoplakia with carcinoma in
situ lesion in the 11 o’clock position. From Burghardt E et
al: Text and atlas: colposcopy—cervical pathology,
New York, 1991, Thieme.
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Low-grade squamous intraepithelial lesion
- Human papilloma virus disease
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Click to enlarge. From Burghardt E et al: Text and atlas:
colposcopy—cervical pathology, New York, 1991, Thieme.
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Click to enlarge. From Burghardt E et al: Text and atlas:
colposcopy—cervical pathology, New York, 1991, Thieme.
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Click to enlarge. From Giuntoli RL et al: Textbook and atlas:
Atkinson's correlative atlas of colposcopy, cytology, and histopathology
, Philadelphia, 1987, Lippincott-Raven.
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Click to enlarge. From Giuntoli RL et al: Textbook and atlas:
Atkinson's correlative atlas of colposcopy, cytology, and histopathology
, Philadelphia, 1987, Lippincott-Raven.
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High-grade squamous intraepithelial lesion
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Click to enlarge. From Giuntoli RL et al: Textbook and atlas:
Atkinson's correlative atlas of colposcopy, cytology, and histopathology
, Philadelphia, 1987, Lippincott-Raven.
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- Severe dysplasia, carcinoma in situ
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Click to enlarge. From Giuntoli RL et al: Textbook and atlas:
Atkinson's correlative atlas of colposcopy, cytology, and histopathology
, Philadelphia, 1987, Lippincott-Raven.
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Click to enlarge. From Burghardt E, Ostor AG et al: Text
and atlas: colposcopy—cervical pathology, New York, 1991,
Thieme.
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Squamous cell carcinoma (invasive)
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Click to enlarge. Somewhat exophytic squamous cell carcinoma
with variety of abnormal blood vessels. From Burghardt E et al:
Text and atlas: colposcopy—cervical pathology, New
York, 1991, Thieme.
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Click to enlarge. Endophytic squamous cell carcinoma. From
Burghardt E et al: Text and atlas: colposcopy—cervical
pathology, New York, 1991, Thieme.
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Click to enlarge. Exophytic squamous cell carcinoma. From Burghardt
E et al: Text and atlas: colposcopy—cervical pathology,
New York, 1991, Thieme.
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Adenocarcinoma (endocervical)
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Click to enlarge. Endocervical adenocarcinoma with atypical
vessels and friable lesion in endocervical curettage. From Giuntoli
RL et al: Textbook and atlas: Atkinson's correlative atlas of
colposcopy, cytology, and histopathology, Philadelphia, 1987,
Lippincott-Raven.
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Cervicitis
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Click to enlarge. From Giuntoli RL et al: Textbook and atlas:
Atkinson's correlative atlas of colposcopy, cytology, and histopathology
, Philadelphia, 1987, Lippincott-Raven.
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Click to enlarge. From Giuntoli RL et al: Textbook and atlas:
Atkinson's correlative atlas of colposcopy, cytology, and histopathology
, Philadelphia, 1987, Lippincott-Raven.
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Cervical polyps
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Click 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.
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Endometriosis
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Click to enlarge. Bluish endometriotic deposit in posterior
fornix. From Burghardt E et al: Text and atlas: colposcopy—cervical
pathology, New York, 1991, Thieme.
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Endometrial biopsy may be helpful in diagnosing:
- Anovulation or inadequate corpus luteal function Absence of
secretory endometrium in the second half of the menstrual cycle suggests
that ovulation has not occurred or the corpus luteum is producing inadequate
progesterone. This may result in erratic vaginal bleeding or infertility.
- Infection
Histology may show endometritis. You can send an endometrial sample
for culture.
- Malignancy or pre-malignant changes (atypical hyperplasia)
- Simple hyperplasia
Simple hyperplasia suggests lack of progesterone.
- Endometrial polyp
This may cause abnormal vaginal bleeding.
- Endometrial atrophy
Endometrial atrophy is seen in menopause or with chronic progestin therapy.
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