Colposcopy technique

Colposcopy technique

MAHMOUD MELEIS MD HEAD OF GYNEONCOLOGY DEPARTEMENT ALEX.

UNIVERRCCITY

Modified Reid colposcopic index(RCI)

1) Color of the lesion.2) Margin of the lesion.3) Blood vessels.4) Iodine testing.

A-Color of the lesion 1) *Low-intensity acetowhitening (not completely opaque). * indistinct acetowhitening. * transparent acetowhitening. *Acetowhitening beyond the margin of the transformation

zonePure. *snow-white colour with intense surface shine.

(Zero score)

2) Intermediate shade - grey/white color and shiny surface (most lesions should be scored in this category . (score 1)

3) Dull, opaque, oyster white; grey (score 2)

B- Margin of the lesion And surface configuration1) Microcondylomatous or micropapillary contour.

Flat lesions with indistinct margins. Feathered or finely scalloped margins

Angular, jagged lesions.Satellite lesions beyond the margin of the transformation zone. (Score zero)

2) Regular-shaped, symmetrical lesions with smooth, straight outlines .(Score 1)

3) Rolled, peeling edges. Internal demarcations between areas of differing colposcopic appearance-a central area of high-grade change and peripheral area of low-grade change .(Score 2)

C-Blood vessels1) Fine/uniform-calibre vessels. closely and uniformly placed . Poorly formed patterns of fine punctation and/or mosaic

Vessels beyond the margin of the transformation zoneFine vessels within microcondylomatous or micropapillary lesions.(score zero)

2) Absent vessels.(score 1)

3) Well defined coarse punctation or mosaic, sharply demarcated and randomly and

widely placed .(score 2) NB: Branching atypical vesseles is a colposcopically

overt cancer

D-Iodine testing1) Positive iodine uptake giving mahogany-brown

colorNegative uptake of insignificant lesion(yellow staining by a lesion scoring 3 0r less on the previous criteria) {score 0}

2) Partial iodine uptake - variegated, speckled appearance.(score1)

3) Negative iodine uptake of significant lesion, i.e., yellow staining by a lesion already scoring four points or more on the first three criteria.{score2}

Reid Colposcopic Index (RCI)

0 – 2 Likely to be CIN 1 3 – 4 Overlapping lesion: likely to be CIN 1 or CIN 2. 5 – 8 Likely to be CIN 2-3

Thin acetowhite lesion with geographic margins in the upper lip. Histology indicated CIN 1

• Mildly dense acetowhite lesions arising from the squamocolumnar junction in 12 and 6 o’clock position with irregular geographical margins, which on histology proved to be CIN 1 lesion

• Note the circumorificial acetowhite CIN 1 lesion with irregular margin and fine mosaics (a(

• Moderately dense acetowhite lesions with irregular margins in the anterior and posterior lips (CIN 1)

• A circumorificial dense opaque acetowhite area with coarse mosaics (CIN 3) lesion.

• A dense acetowhite, opaque, complex, circumorificial CIN 3

• Invasive cancer: There is a proliferative growth on the cervix which becomes dense, chalky white after the application of acetic acid. Bleeding partly obliterates the acetowhitening

Lesion size