Fig. 10.1
Hysterectomy specimen of the uterus and cervix
Fig. 10.2
Specimen showing internal and external os
10.2 IFCPC Classification (2011)
Normal colposcopic findings include:
- 1.
Original squamous epithelium
- 2.
Columnar epithelium
- 3.
Ectopy
- 4.
Transformation zone 1,2,3
- 5.
Deciduosis of pregnancy
- 6.
Atrophic epithelium
- 7.
Nabothian cyst
- 8.
Gland openings
The original squamous and columnar epithelium have been discussed in Chap. 1.
10.3 Ectopy
It is the presence of glandular epithelium on the portio of the cervix. It refers to the presence of endocervical tissue or mucus-secreting epithelium, on the portio vaginalis of the uterine cervix (Fig. 10.3). Erosion is a misnomer.
Fig. 10.3
Ectopy with peripheral area of immature squamous metaplasia
10.4 Transformation Zone
An imaginary line drawn connecting the most distal crypt openings and/or nabothian follicles that one can see in the cervical lips colposcopically defines the original squamocolumnar junction (the junction between the original or native squamous epithelium and the metaplastic squamous epithelium). The new squamocolumnar junction is the line of demarcation where the metaplastic squamous and columnar epithelia meet.
The area between the old and new squamocolumnar junction is the transformation zone.
The vast majority of CIN changes occur in the transformation zone, and the most severe changes tend to abut, rather than farther from, the new squamocolumnar junction.
A variable zone of young squamous cells lies at the area of transformation between multilayered squamous epithelium of ectocervix and the single-layered, mucus-secreting columnar epithelium of endocervical canal.
There are three types of transformation zones (Figs. 10.4, 10.5, and 10.6):
Fig. 10.4
Diagrammatic representation of TZ-1
Fig. 10.5
Diagrammatic representation of TZ-2
