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PubMed1991

[Colposcopy of the vulva].

A detailed colposcopy study of the cervix, vagina and vulva was conducted in 365 women referred for genital human papillomavirus (HPV) lesions, abnormal cervico-vaginal smear or cervical intraepithelial neoplasia (CIN). Valvuloscopic abnormalities, all biopsied, were found in 144 women, i.e. 40% of the population studied. Five types of vulvoscopic abnormalities are described: diffuse acidophilia (55% of abnormalities), acidophilic maculae (17%), micropapillae (20%), papulae (4%) and leucoparakeratosis (4%). Histological examination of the biopsy specimens obtained from 144 women with abnormal vulvoscopy showed 55 typical flat condylomas (38%), 50 probable flat condylomas (35%) and no signs of condyloma in 38 cases (27%). It also revealed the presence of four vulvar intraepithelial neoplasias (VIN) stages 2-3, all of them associated with typical or probable condyloma. Comparison between the 144 abnormal vulvoscopies and a series of 14 normal vulvoscopies made it possible to establish a significant correlation between the presence of valvuloscopic abnormalities and the finding of histological signs of typical or probable flat condyloma. The vulvoscopic images of subclinical vulvar HPV infection, but apart from papulae and, to a lesser extent, leucoparakeratosis, correlations between vulvoscopic and histological images were imprecise.

Acetates↗
PubMedDate not supplied

Colposcopy of patients with cytologic inflammatory epithelial changes.

Of 3,308 cervical cytologies performed at a university health service between September 1986 and September 1987, 371 were reported as showing inflammatory epithelial changes (IECs). Colposcopy was offered to all patients with this diagnosis and was actually performed on 200 (54%). Of these women, 44 had an atypical transformation zone; of the 33 who were biopsied, 23 had histologic diagnoses ranging from human papillomavirus (HPV) infection (4 cases) to grade III cervical intraepithelial neoplasia (CIN; 4 cases). Most biopsies showed CIN I. In our clinic, the 95% confidence limits for the histologic diagnosis of HPV or CIN in women with a cytologic diagnosis of IEC are 8.5% to 23.5%. Colposcopic examination of women with IEC may be able to detect patients with CIN who are missed by standard cytologic screening. Concerns about a potential bias from false-positive histology reports must be resolved before such an approach can be recommended.

Biopsy↗
PubMed1989

[Diagnostic reliability of pre-biopsy methods (colposcopy and cytology) in predicting the histological basis of cervical lesions].

The more frequent incidence of cancer of the uterine cervix and thus of precanceroses in younger age groups, the introduction of new therapeutic methods (cryotherapy, CO2 laser, modernized diathermocoagulation) call for an estimate of the histological basis of the cervical lesion and in precanceroses assessment of its grade. These data must be provided by prebioptic methods (cytology and colposcopy). This diagnosis is essential to provide optimum therapy under the given circumstances. During the two-year period of 1985-1986 at the Gynaecological Clinic in Plzen 308 women detected by cytological screening were examined who were subsequently operated on account of a cervical lesion. In the investigated group a prebioptic predicition of high reliability was made. A concordant finding was recorded in 286 women, i.e. 92.9%. False negative, i.e. so-called risk errors were made in 9 women, i.e. 2.9%. False positive errors without risk, where the only consequence was unnecessarily radical treatment, were made in 13, i.e. in 4.2% women.

Adult↗
PubMed1989

The Colposcopy Clinic Data System.

Microcomputers are well suited to general data management, yet applications have not been available to meet the highly specialized requirements of a colposcopy clinic. Software was developed under the hypothesis that a specifically tailored application could improve the quality of patient care and facilitate medical education.

Colposcopy↗
PubMed1986

[Male genital lesions caused by papillomaviruses. Importance of colposcopy].

Ten years after the description of cervical flat condyloma, it is now admitted that Human Papillomaviruses (HPVs) type 6 and 11 are responsible for condylomata acuminata and typical flat condyloma of the uterine cervix. HPV DNA type 16 and, less frequently, 18, 33 and other as yet uncharacterized HPV types (G. Orth, personal communication), are found in the majority of Cervical Intraepithelial Neoplasia (CIN), Vulvar Intraepithelial Neoplasia (VIN) and cervical and vulvar invasive cancers. Since HPVs are sexually transmissible, recent interest has focused on the "male factor". Clinically detectable lesions of male genitalia are condylomata acuminata, bowenoid papulosis and flat condyloma-like papules. The aim of our study was the colposcopical screening, recently suggested, of different groups of male patients in order to detect HPV-related lesions and the description of the colposcopical features of subclinical HPV-related lesions, since most of them have never been reported, to our knowledge, in the literature. A total of 114 men were examined. Among them, 18 presented clinically detected recalcitrant condylomata acuminata, 28 had been treated for the same pathology 1 to 5 days earlier and were clinically free of lesions, 46 were sexual partners of women with cervical atypia (flat condyloma and/or CIN) and 22 had a clinical diagnosis of genital infection without HPV-related lesions. A careful examination of external genitalia was performed. Then all patients underwent penile colposcopy before and after application of 5 p. 100 acetic acid. Selected biopsies were performed in all lesions which were clinically and colposcopically different from classic warts. Colpophotographs were taken in all cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Colposcopy↗
PubMed1988

The colposcopy and the cone biopsy in the diagnosis, treatment and follow-up of 81 cases of cervical intraepithelial neoplasia.

A conization was performed on 81 patients with histological diagnosis of cervical intraepitelial neoplasia (CIN), whom and previously a rigorous colposcopic examination. 64 patients were younger than 35 years. The previous strict colposcopic examination determined that in none of the cases were the surgical margins of the cone biopsy affected: In 26 cases there was no correlation between the previous biopsy and the histological diagnosis of the cone biopsy. The latter was--higher in degree in 9 cases and, in addition to this, in the 23 histerectomies that were performed after the conization, 7 surgical specimens showed CIN in their histological study. The non-involved surgical margins--that could be obtained in those cases with a careful previous colposcopy,--can not guarantee the exeresis of all the CIN zones. The biopsy of an atypical zone, in a colposcopic extensive lesion, cannot be representative of the whole lesion. In the follow-up--5 years maximum and 1 year minimum--3 relapses had appeared and 9 pregnancies had been diagnosed, that had not showed an increase in the number of premature labours, nor in the cesareas-rate.

Adolescent↗
PubMedDate not supplied

Computerized recording and reporting system for cytology and colposcopy.

The computerized system for recording and reporting cytologic and colposcopic data at the Madrid Provincial Hospital is discussed. Cytodiagnostic codes based on standard international nomenclature, and yet open to constant updating, were created for the anatomic sites from which samples are currently examined (vagina and cervix, endometrium, vulva and breast), with areas allocated for expansion to other sites. A similar novel code was devised for colposcopic data. Specific forms were developed for each anatomic site; the cervicovaginal and endometrial forms are used for both cytology and colposcopy. The system has provided the laboratory with automation of its managerial, clerical and administrative tasks, including (1) record keeping, (2) reporting, (3) statistics, (4) correlation of clinical, cytologic, colposcopic and histopathologic data, (5) patient follow-up, (6) technical support in research programs and (7) quality control. Use of the system led to an improvement in the efficiency of the laboratory and resulted in reports of better quality. The program has been of help in our research and has not increased the total cost of cytologic studies.

Breast↗
PubMed1987

Correlation of colposcopy and histology findings in pre-clinical neoplasia of the cervix.

The histology findings of pre-clinical neoplasia of the cervix at cone biopsy were compared with the previous colposcopic assessment in fifty-eight patients. In 84.5% of cases colposcopy prediction was within one grade of the histology findings. This close correlation is important where suitability for local ablative therapy depends on accurate colposcopic assessment prior to tissue destruction.

Biopsy↗
PubMed1986

Abnormal Pap smear: colposcopy and cryosurgery.

Colposcopic evaluation of patients with abnormal Papanicolaou smears permits the physician to visualize cervical lesions and determine the extent of intraepithelial neoplasia. Through the use of colposcopy with cryotherapy, many patients with cervical intraepithelial neoplasia may avoid a more invasive form of treatment. Family physicians should become familiar with colposcopic technique so that they can select patients who are suitable for local treatment with cryotherapy.

Cervix Uteri↗
PubMed1986

[Colposcopy in dysplasia, carcinoma in situ and microinvasive cancer of the cervix--systematic diagnosis].

Recently colposcopy has come to be increasing used in the diagnosis of the early cervical cancer. We studied colposcopic findings (epithelial, vascular and glandular findings) of dysplasia, carcinoma in situ and microinvasive cancer of the uterine cervix. The results were as follows. We could classify the cases without white epithelium into microinvasive cancer and carcinoma in situ according to elevation or hollowness and roughness and the cases with I grade white epithelium (thin white epithelium) into severe dysplasia and mild or moderate dysplasia according to the existence of elevation, roughness, II type vessels and elevation of gland opening. Among the cases with II grade white epithelium (thick white epithelium) those without roughness, II type vessels and increased gland opening were mild or moderate dysplasia and most case with III or IV type vessels were microinvasive cancer. We concluded that more than half of the cases without III or IV type vessels spread to transverse pollution of white epithelium and lack or indefiniteness of gland opening, severe dysplasia with 0 finding, carcinoma in situ with 1 or 2 finding and microinvasive cancer with 3 findings. With these criteria, we were able to obtain high (93.4% with mean) correct diagnostic ratios.

Carcinoma in Situ↗
PubMed1985

Role of endocervical curettage in colposcopy.

Two-thousand three-hundred and four patients with abnormal cervical cytology were evaluated by colposcopy, cervical biopsy, and endocervical curettage. The endocervical curettage was more accurate than the cervical biopsy in 1.2% of patients with satisfactory colposcopic examinations, 15.7% of patients with unsatisfactory examinations, and 30.5% of patients with no lesions observed. The endocervical curettage contained neoplastic epithelium in all 15 of the patients with invasive cancer and in seven patients it was the only diagnostic parameter that indicated invasion. The information from the endocervical curettage, when correlated with the cervical cytology, colposcopic findings, and cervical biopsy, eliminated the need to do a diagnostic conization in 76% of patients with unsatisfactory examinations and 79% of patients with no lesion identified. It is recommended that the endocervical curettage be a part of every colposcopic examination.

Adult↗
PubMed1979

[Preoperative evaluation by colposcopy and cytology in cervical intraepithelial neoplasia (cin) (author's transl)].

Before conization in 108 patients with cervical intraepithelial neoplasia (CIN) colposcopic findings and the results of triple cervical smears (anterior and posterior cervical lip and endocervical canal) have been evaluated and compared with the microscopic findings, limiting the comparison to the separately investigated anterior and posterior cervical lips. Colposcopically and cytologically suspicious findings agreed with the microscopic findings of CIN in 48.3% (anterior lip) resp. 41.7% (posterior lip). Cytologically suspicious findings alone have been determined in 80.5% resp. 84.8%; colposcopically suspicious findings were found in 55.2% resp. 48.1%. The main causes of false negative smears may have been failures of sampling, of false negative colposcopical findings a wrong estimation of an atypical transformation zone. A combined application of colposcopy and triple cervical smear technique in patients with abnormal smears is strongly recommended. This may improve the results of localizing a lesion of CIN.

Adult↗
PubMed1979

Colposcopy in anorectal disease.

The colposcope was introduced into colon and rectal surgery for the evaluation of anal and perianal disease. The standard technics of gynecologic colposcopy were used. The indications included evaluations of pruritus ani, condyloma, mass lesions, unexplained bleeding or pain, and follow-up of patients previously treated for carcinoma of the anus or lower rectum.

Anus Diseases↗
PubMed1984

[The laboratory and colposcopy in the diagnosis of urogenital trichomoniasis].

Urogenital trichomoniasis is a very common condition, the most frequent veneral disease in women. It is also the commonest cause of vaginal discharge. Nevertheless, it is often unrecognised since attenuated, latent, unusual forms are more numerous than acute forms which might lead to a suspicion of the diagnosis, and because the investigations which are necessary to make the diagnosis are not made often enough. Two types of investigation are available: laboratory studies to seek the parasite and colposcopy which reveals characteristic appearances. However, each may miss the diagnosis in some 25% of cases and should therefore not be seen as being mutually exclusive. Their combined use should ensure that few cases go undiagnosed.

Acute Disease↗
PubMed1984

Colposcopy in the management of cervical dysplasia.

A follow-up study was carried out on 27 patients with high dysplasia and 133 patients with mild dysplasia for at least 1 year, using mainly cytodiagnosis and colposcopy. Advanced cases were identified in 25.9% of the first group and 8.3% in the latter group. It was demonstrated that these advanced cases could be found without fail from colposcopic findings combined with cytodiagnosis.

Colposcopy↗
PubMed1984

[Analytical diagnosis in colposcopy by subdivision of abnormal findings].

Abnormal findings of Colposcopy (Colp) were classified in contrast with histology. Varieties of colposcopic abnormal findings appear in more advanced changes in cervical diseases; single in squamous metaplasia, dysplasia and some Ca in situ, double in Ca in situ and microinvasive Ca, triple microinvasive and advanced carcinoma. Atypical vessels are frequently encountered in invasive carcinoma. Circular extension of abnormal figures around external os indicated the following correlation: Within 1/4-2/4 in dysplasia, 2/4-3/4 in Ca in situ and microinvasive Ca, 3/4-4/4 in microinvasive and invasive Ca. In squamous metaplasia and dysplasia, the white epithelia were flat on the surface, comparatively clear in the white part and less elevated. On the other hand, in carcinoma in situ, corresponding to the pathological area, they were rough on the surface, unclear in the white part and highly elevated. Compared with squamous metaplasia and dysplasia, carcinoma in situ in punctation revealed more surface elevation and unclear white part. Characteristic histological figures are dot types in the metaplasia and dysplasia, nest-like types in the carcinoma in situ and atypical vessel transition types in the microinvasive carcinoma. Complete types of mosaic were observed more in metaplasia, slight dysplasia and carcinoma in situ, while the incomplete types were common in moderate and severe dysplasia. Microinvasive carcinoma mosaic revealed more incomplete types and atypical vessel transition types. As for surface elevation and unclear white part, the same tendency was noticed as in punctation and white epithelium.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma, Squamous Cell↗
PubMed1984

[Approach to the diagnostic colposcopy--a scoring method of colposcopic pattern].

In order to arrive at a final diagnosis of early cervical cancer by colposcopy alone, a colposcopic scoring system was applied to 172 patients with the disease. Each colposcopic pattern was scored from one point (for white epithelium) to 9 (for invasive cancer). The results obtained were as follows; 1) With these scoring criteria, stage 0 cancers were restricted to below 10 points and were characterized colposcopically by white epithelia with gland openings 2) In stage I-a lesion, atypical vessels, punctuation by irregular arrangement of the dots and concentration of abnormal gland openings were usually observed, and these findings were combined with each other to show a more complicated colposcopic pattern reflected in 11 to 18 points of the score 3) Frank invasions were indicated by 19 points or more, and punctuations or mosaics were seldom found in this stage, although the early "I-b" cancer was difficult to distinguish from I-a with this method 4) The diagnoses from this scoring system were identical with the final diagnoses confirmed by surgical methods in 66.7% of stage 0, 59.4% of I-a and 76.5% of I-b.

Cervix Uteri↗