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At least 19 recordsLinked to original sources
PubMed1976

Colposcopic evaluation of patients with abnormal cytologic smears during pregnancy.

One-hundred thirty-two patients with abnormal Papanicolaou smears of the cervix uteri during pregnancy underwent colposcopic evaluation. Seventy-five patients had biopsies during pregnancy, and 34 patients had colposcopic evaluation without performing any biopsy. Postpartum colposcopic evaluation was performed on 95 patients. In 93 patients of this group, the postpartum cytologic and histologic information obtained was the same or less than that obtained in antepartum evaluation. In only 1 case, antepartum colposcopically guided biopsy at 38 weeks' gestation revealed moderate dysplasia, and postpartum cold conization showed carcinoma in situ. In another case, colposcopic evaluation and biopsy during pregnancy showed mild dysplasia while colposcopic biopsy as well as examination of a hysterectomy specimen taken at 16 months after delivery revealed severe dysplasia. No case of invasive carcinoma was missed during pregnancy. The results of this study, in support of previous reports, show that colposcopic evaluation is a simple, safe, and accurate method of investigating abnormal Papanicolaou smears during pregnancy.

Adolescent↗
PubMed1976

Colposcopic evaluation of patients with abnormal cervical cytology.

Because of suspicious or abnormal smears, 620 patients were referred to the Colposcopy Clinic of the British Columbia Cancer Institute between 1st March 1973 and 31st December 1974; it was possible to make a colposcopic examination in 549 of these patients (88.5 per cent). The colposcopic impression was within one histological grade of a colposcopically-directed biopsy in 476 patients (86 per cent). There were 221 patients who had a cone biopsy after a colposcopically-directed biopsy and in 192 of these (87 per cent) the two biopsies were within one histological grade of each other; but there were two patients with occult invasive carcinoma in a cone biopsy and only carcinoma in situ in a directed biopsy. In the same group of 221 patients the colposcopic evaluation and final diagnosis (the most advanced histological lesion seen in biopsy) agreed in all but seven patients.

Adult↗
PubMed1975

[Therapeutic results of colposcopically controled collection of cervix tissue in atypical smears of women up to the age of 35 years].

The case series consists of 106 women consecutively collected during 1968 to 1973 from those with a vaginal smear belonging to Papanicolou's groups III and attending the gynaecological department in Umeå. Probably the series is a fair random sample of the population (congruent to 150,000 people) of the area served by the clinic. The extension of the colposcopically delimited atypical transformation zone (with its upper bordèrline against normal cervical villi) in most cases being small, the surgical procedure--a small cone congruet to ring biopsy--was accordingly insignificant. In 9 cases only a large conization was performed. As only a small part of the cervical tissue was usually removed it is probable that the enzymatic and mechanical properties of the cervix as well as its capacity as a sperm reservoir could be preserved. The median of the observation time is 26 months, range 3 months to 5 years. At the follow up the colposcopic and histological picture has so far shown no sign of atypia in 91 subjects. The same applies cytologically to the patients subjected to a large conization. Two women have moved away from the district. A relapse occurred in 4 patients, who after a large conization have remained cytologically negative. Throughout the investigation the term a typia has been used to characterize the cytological, colposcopic and histological changes, the degree and extension of this atypia being taken into considertion. Thus the abstruse nomenclature in common use is avoided. Cytological atypia is cellular in character, while histologically it includes the degree of structural derangement of the epithelial architecture as well. Colposcopically the angioarchitecture and the capillary distance seem to be the most important features. The correlation between the colposcopic and the cytological and histological findings is high when the degree of atypia is marked. It is inferred, therefore, that the descriptive term atypia should replace the superfluos bulk of terms in the fields in question.

Colposcopy↗
PubMed1979

Evaluation of colposcopic accuracy without endocervical curettage.

A study was undertaken to evaluate the accuracy of colposcopic examination when performed without the use of endocervical curettage. It included 763 cases of suspected cervical-vaginal pathology. An additional evaluation of colposcopic accuracy was made for special-case categories of 1) stromal invasion, 2) pregnancy, 3) menopause, and 4) diethylstilbestrol (DES) exposure. Colposcopic accuracy was determined by cytologic and histologic material obtained either at the initial colposcopic evaluation or during follow-up surgery. With the literature as a standard for accuracy, it was concluded that the omission of endocervical curettage from the colposcopic examination did not reduce accuracy. In addition, the diagnostic conization rate was lower than in most reported series. Finally, the rate of missed invasive lesions was not increased by the omission of endocervical curettage.

Adolescent↗
PubMed1977

Colposcopic evaluation of patients with abnormal cervical cytology.

A total of 1580 new patients underwent colposcopic evalution in the Dysplasia Clinic at Nassau County Medical Center. Of these patients, 186 had abnormal Papanicolaou smears associated with pregnancy, 150 were referred because of in utero exposure to diethylstilbestrol, and 1244 were referred because of abnormal cervical cytologic smear or suspicious cervical or vaginal lesion. Further analysis of this latter group revealed that 1184 (95%) patients had satisfactory colposcopic evaluation, and directed biopsy showed the following: 10 cases of invasive cervical carcinoma, 9 of carcinoma in situ with microinvasion, 118 of cervical carcinoma in situ, 110 of severe dysplasia, and 424 cases of mild to moderate cervical dysplasia. All of these patients subsequently were treated accordingly. Evaluation of final histologic specimen revealed a very high correlation with colposcopically guided biopsies. In 54 patients, where colposcopic evaluation was unsatisfactory, diagnostic cold knife conization was performed. Final histologic diagnosis disclosed a more advanced lesion in 30 patients (or 56%) of this group. The result of this study shows that satisfactory colposcopic evaluation is a highly accurate method of evaluation of abnormal cervical and vaginal cytologic smear.

Adolescent↗
PubMed1992

Colposcopic diagnosis of HPV cervical lesions.

The colposcopic criteria for abnormal epithelium are leukoplakia, a white area detected after the application of acetic acid or iodine-negative areas not reacting to the acetic acid test. However, white epithelium and iodine-negative areas are not specific for abnormal tissue, condyloma or intraepithelial neoplasia. The lack of specificity of colposcopic findings has motivated the distinction between minor and major grade abnormalities in the recently proposed new colposcopic terminology. Metaplasia and dysplasia cannot be distinguished by colposcopy. All criteria proposed so far lack specificity and reproducibility. Thus, it is at present considered that colposcopy is not a diagnostic method, but an investigative technique that allows the evaluation of the extent of the lesion and localization of the squamo-columnar junction. As for the distinction between condyloma and high-grade intraepithelial neoplasia, all criteria proposed so far also lack reproducibility. Moreover, condyloma is often found at the periphery of high-grade CIN, rendering such a distinction meaningless. The only features specific of HPV infection without dysplasia are condyloma acuminatum and, to a lesser extent, non-acetowhite microcapillary surfaces. Finally, it has been shown that there is no colposcopic sign specific of HPV types.

Carcinoma↗
PubMed1992

Colposcopic pictures of Abnormal Transformation Zone (ANTZ): colpocytological and histological findings.

The Authors have examined the correlation between the colposcopic pictures of the Abnormal Transformation Zone (ANTZ), in its varying degrees, and the colpocytological and histological examinations in order to seek a better definition of the indications of carrying out aimed biopsies. From our results a good agreement has been observed from the colpocytological and histological examination and the colposcopic pictures of the ANTZ. In patients with colposcopic images of ANTZ G2 the colpocytological examination diagnosed a CIN 3 in 80.6% of cases, invasive carcinoma in 6.4%, and in histologic examination CIN 3 in 71% and microinvasive carcinoma in 10.7%. Instead in the ANTZ G1, CIN 3 was revealed colpocytologically in 7.9% of the cases and histologically in 7.3%. Among these last, in half of the cases, the focuses of CIN 3 were present at the level of third inferior of the cervical canal. Finally, in ANTZ G0 there was cytological evidence in 6.6% of cases of CIN 3 with a histological correspondence of 3.9%. In particular the focuses of CIN 3, small and limited, had resulted from biopsies carried out on some glandular openings not clearly attributable to ANTZ G1. With regard to the opportuneness of carrying out aimed biopsies, mandatory in the cases of ANTZ G2, we feel it would be useful to carry them out also for ANTZ G1, above all if alterations are diagnosed at the colpocytologic examinations, and in ANTZ G0 if colpocytological alterations are present. Therefore integrating colposcopic and colpocytologic examinations and aiming the biopsies would seem to lead to good diagnostic reliability and adequate successive personalized treatment.

Adult↗
PubMed1992

A population-based study of microinvasive disease of the cervix--a colposcopic and cytologic analysis.

A study of 61 cases of microinvasion of the cervix occurring in our population between 1980 and 1989 is reported. The mean age of the women was 39 years, compared with 30 years for cervical intraepithelial grade 3 (CIN III) and 47 years for frank invasion, respectively. Colposcopic suspicion of microinvasion was present in 31 cases, giving a sensitivity of colposcopic diagnosis of 50% and a specificity of 91%. In 21 cases (34%) there was no suspicion either cytologically or colposcopically of microinvasion. Colposcopy predicted microinvasion more accurately with increasing depth of invasion. In 28 women there had been previous smears within 10 years available for review. The time interval between the first abnormal smear and the histological diagnosis ranged from 1 month to 9.8 years (mean, 4 years).

Adult↗
PubMed1978

Colposcopically directed cone biopsies in the management of cervical intraepithelial neoplasia.

Thirty-three patients with severe dysplasia and carcinoma in situ had a colposcopically directed cone biopsy in the operating room immediately prior to vaginal hysterectomy. In 3 cases (9%), the hysterectomy specimen showed the same type of residual disease as in the cone biopsy; in the remainder no residual disease was evident in the hysterectomy specimen. If colposcopically directed biopsies were performed, the long-term debate over the use of cone biopsy or hysterectomy for intraepithelial neoplasms would be resolved. Selected patients could be treated adequately by cone biopsy with a small number of patients requiring hysterectomy as indicated by direct examination with the colposcope.

Biopsy↗
PubMed1976

Colposcopic management of abnormal cervical cytology during pregnancy.

A total of 104 pregnant patients with abnormal cervical cells were referred to the Dysplasia Clinic for evaluation and management by colposcopy. Seventy-one pregnant patients presenting with basal cell atypia on cytologic examination had colposcopically directed biopsy revealing 8.45% severe dysplasia and 1.41% carcinoma in situ. Cytologic study in 31 pregnant patients with basal cell dysplasia revealed severe dysplasia in 29% and carcinoma in situ in 12.9% of the colposcopic biopsies. Cervical cytology revealed carcinoma in situ in two patients. Directed biopsy in both cases revealed carcinoma in situ with one case of questionable microinvasion. Colposcopically observed normal and abnormal physiologic findings and the pregnant cervix, complications after conization during pregnancy, and the impact of colposcopy in the management of the cytologically abnormal cervix during pregnancy are discussed.

Adult↗
PubMed1977

Colposcopic evaluation of pregnant patients with abnormal cervical smears.

Colposcopic examination and biopsy were used to assess 123 pregnant patients presenting with abnormal cervical smears. Eighty-seven per cent were 30 years of age or less and 95 (77 per cent) had had one or no previous children. Two patients were found to have microinvasive carcinoma and, in an additional 95 patients, either severe dysplasia or carcinoma in situ was present. Fifty-five patients (45 per cent) had subsequent conization or hysterectomy and in no instance was the histological diagnosis more serious than that anticipated from the colposcopic evaluation. Only three patients (1-6 per cent) had a cone biopsy during pregnancy; only one minor complication occurred. Colposcopic examination is the choice method of evaluating patients with abnormal cervical smears in pregnancy.

Adolescent↗
PubMed1976

[Comparative colposcopic, cytological and histological studies of the uterine cervix during pregnancy].

The suspected findings, of colposcopic and cytologic cervix uteri in the pregravidity, was reported. Among 5852 patients, who primarily were directed in the clinic for interruption, 63 of them were examined because of their suspected colposcopic results and 3 cases of them were examined because of their suspected cytologic results, at the same time a detailed histological clarifications of their portio during the interruption were made. About 30,8% of the cases were in preinvasive or invasive stages, which were histologically clarified and precarcinogenic treatment of the patients was carried out. On the evidence of the results, we recommend, that by all suspected colposcopic cases -- taken into consideration of the cytologic results -- an early histologic clarification be made.

Abortion, Induced↗
PubMed1978

Colposcopic examination of the cervix of cebus monkeys.

A total of 410 colposcopic examinations were performed on 188 female cebus monkeys that were under study to determine the oncogenic potential of herpes simplex virus type 2 in this genus. A split-cone vaginal speculum was developed that permitted good observation of the vaginal cervix in the cebus monkey. The cervical anatomy of cebus monkeys was found to differ from that of humans in that the surface of the animal cervix was more papilliform, with thinner squamous epithelium, and the squamocolumnar junction lay within the endocervical canal. Therefore, the ability to detect abnormalities in the cervical epithelium by colposcopic examination in the cebus monkey was restricted to vascular changes in the squamous epithelium. After 100 examinations, several vascular patterns were distinguishable and interpretations of these patterns were compared with cytologic findings on the same animals. Findings by both cytology and colposcopy were mild in nature; no carcinoma was detected. Colposcopic and cytologic findings correlated at a level of 84%. More abnormalities were detected with colposcopy than with use of cytologic techniques.

Animals↗
PubMed1978

Comparison of histologic and colposcopic findings in DES-exposed females.

A study was undertaken to evaluate the histologic alterations associated with two of the most abnormal colposcopic findings, mosaicism and punctation, that are commonly found in the vaginas and cervices of young women who have been exposed prenatally to diethylstilbestrol (DES). Four-fifths of 215 biopsy specimens from 171 exposed subjects with mosaicism or punctation disclosed metaplastic squamous epithelium, the presence of which is thought to reflect the repair of vaginal adenosis and cervical ectropion. Hyperkeratosis was observed in one-fifth of the specimens and was more frequent in lesions colposcopically graded I than II. Mild dysplasia was encountered in only one specimen. The findings indicate that the presence of squamous cell dysplasia cannot be predicted by the finding of Grade I or II mosaicism or punctation in the DES-exposed female despite the fact that these abnormal colposcopic patterns are associated with dysplasia in about 10% of cases when encountered in the cervix of the unexposed woman.

Colposcopy↗
PubMed1977

[Diagnostic conization of the uterine cervix. II. Comparison of histological diagnoses with cytological and colposcopic tentative diagnoses].

This report presents colposcopic and cytologic misinterpretations in cases with a cervical intraepithelial neoplasia or early invasive carcinoma and benign cervical lesions and the accuracy of these two methods of screening for cervical cancer. The accuracy of the cytology and of the colposcopic impression in predicting the degree of cervical intraepithelial neoplasia and early invasive carcinoma was over 93 per cent. In patients showing benign cervical lesions the cytology is more accurate in predicting the correct histologic change with 94,2 per cent than the colposcopic impression with 63,1 per cent. The suspicious smears (Papanicolaou III) are discussed.

Carcinoma in Situ↗
PubMed1976

Vaginal adenosis. Factors influencing detection in a colposcopic evaluation.

In a colposcopic evaluation of DES-related genital abnormalities, biopsy-proven adenosis was detected in the vaginal walls or hood in 84.5% of 220 women. Patient selection (DES history only vs prior examination) did not significantly influence the detection rate for adenosis. However, the detection rate of adenosis in the vaginal walls showed highly significant correlations with the presence of cervical ectopy and/or hood and with the colposcopic appearance of the area biopsied. Using colposcopy, the columnar pattern had a diagnostic accuracy of 94.4%; mosaic pattern, 85.5%; and white appearance, 68.0%. Differences in the histologic features of mucosal surface glandular tissue, squamous metaplasia, and nonglycogenated squamous mucosa were related to specific colposcopic patterns and helped to account for the variation in the accuracy of the three appearances in detecting adenosis. Biopsy specimens of the hood were not necessary to achieve a high yield of adenosis although we obtained evidence that the hood contains microscopic features typical of vaginal adenosis. Epithelial atypicality in the vagina (moderate squamous cell dysplasia) was demonstrated in only 1 patient.

Adolescent↗
PubMed1975

Colposcopic evaluation of the abnormal Papanicolaou test in pregnancy.

Colposcopy, including colposcopically directed biopsies in selected cases, was employed to evaluate over 300 pregnant patients with abnormal Papanicolaou tests suggestive of mild dysplasia or worse (Class III to V). Over half of the patients had benign disorders determined by colposcopic examination. All cases of invasive disease were diagnosed by colposcopy and biopsy, and the patients were treated accordingly. Only 3 diagnostic conizations were necessary in the antepartum period. The majority of patients with cervical intraepithelial neoplasia were seen post partum, and appropriate therapy was instituted. In the pregnant patient with an abnormal Papanicolaou test, colposcopy has proved to be a reliable and safe method of evaluation and has virtually eliminated the need for conization.

Biopsy↗
PubMed1992

Predictive value of human papillomavirus DNA detection by filter hybridization and polymerase chain reaction in women with negative results of colposcopic examination.

This study focused on women who had an abnormal Papanicolaou smear and a subsequent colposcopic examination negative for a cervical squamous intraepithelial lesion. Cervical swabs obtained during the initial colposcopic examination were analyzed for human papillomavirus (HPV) DNA, and these results were correlated with the follow-up examinations. Human papillomavirus DNA was detected by dot-blot hybridization in 31 of 109 (28%) cases. The rate of subsequent biopsy-proved squamous intraepithelial lesion was 17 of 31 (55%) for the HPV-positive group compared with 9 of 78 (11%) for the HPV-negative group. The HPV-DNA detection rate by polymerase chain reaction was 46 of 109 (42%), with a rate of subsequent squamous intraepithelial lesion of 18 of 46 (39%) for the HPV-positive group, compared with 8 of 63 (13%) for the HPV-negative group. Most women had no evidence of squamous intraepithelial lesions on follow-up if the concurrent Papanicolaou smear was normal, even when HPV DNA was detected, suggesting that HPV detection per se does not necessarily correlate with subsequent squamous intraepithelial lesion.

Cervix Uteri↗