|
2011 IFCPC Colposcopic terminology of the cervix
In the attempt to facilitate international communication related to colposcopic terminology, International Federation of Colposcopy and Pathology of the Cervix has formed a Committee for nomenclature, which adopted the first terminology in 1981.
With the improvement of knowledge and the use of the first terminology in practice, it became clear that it did not satisfy all requirements of colposcopy. It was felt that the old terminology was not appropriate any more, to describe all colposcopic appearances in the broad category of atypical Transformation Zone. This lead to the development of international nomenclature in colposcopy, which was approved by IFCPC during the 8th world congress in Rome, in 1990. This classification was used for more than two decades. It was based on the fact that most of CIN lesions develop in the Transformation zone. It also recognized abnormal colposcopic pictures, such as HPV changes, often appearing in original squamous epithelium and having small or no neoplastic potential.
However, this classification has also not been ideal. This is why new Colposcopic terminology has been worked on during last few years. Finally, new Colposcopic terminology of the Cervix, Vagina and Vulva was adopted during the 14th World congress of the International Federation of Colposcopy and Cervical Pathology which was held in Rio de Janeiro, Brasil from 4-7, July 2011.
2011 IFCPC Nomenclature¹
Accepted in Rio World Congress, July 5, 2011
Nomenclature Committee chairman: Jacob Bornstein MD
|
2011 IFCPC colposcopic terminology of the cervix¹
|
|
General assessment |
- Adequate/inadequate for the reason . . . (i.e.: cervix obscured by inflammation, bleeding, scar)
- Squamo-columnar Junction visibility: completely visible, partially visible, not visible
- Transformation zone types 1,2,3
|
|
Normal colposcopic findings
|
Original squamous epithelium:
Columnar epithelium
Metaplastic squamous epithelium
- Nabothian cysts
- Crypt (gland) openings
- Deciduosis in pregnancy
|
Abnormal
colposcopic
findings |
General
principles |
Location of the lesion: Inside or outside the T-zone,
Location of the lesion by clock position
Size of the lesion: Number of cervical quadrants the lesion covers,
Size of the lesion in percentage of cervix, |
|
Grade 1
(Minor) |
Thin aceto-white epithelium
Irregular, geographic border |
Fine mosaic,
Fine punctation |
|
Grade 2
(Major) |
Dense aceto-white epithelium,
Rapid appearance of
acetowhitening,
Cuffed crypt (gland) openings |
Coarse mosaic,
Coarse punctuation,
Sharp border,
Inner border sign,
Ridge sign |
|
Non
specific |
Leukoplakia (keratosis, hyperkeratosis), Erosion
Lugol's staining (Schiller's test): stained/non-stained |
|
Suspicious for invasion
|
Atypical vessels
Additional signs: Fragile vessels, Irregular surface, Exophytic
lesion, Necrosis, Ulceration (necrotic), tumor/gross neoplasm
|
| Miscellaneous finding |
Congenital transformation zone,
Condyloma,
Polyp (Ectocervical/ endocervical)
Inflammation, |
Stenosis,
Congenital anomaly,
Post treatment consequence,
Endometriosis |
|
2011 IFCPC colposcopic terminology of the cervix - addendum¹
|
|
Excision treatment types |
Excision type 1,2,3 |
|
Excision specimen dimensions |
Length - the distance from the distal/external margin to the proximal/internal margin
Thickness - the distance from the stromal margin to the surface of the excised specimen.
Circumference (Optional)- the perimeter of the excised specimen |
|
2011 IFCPC clinical/colposcopic terminology of the vagina¹
|
General
assessment |
Adequate/inadequate for the reason (i.e: inflammation, bleeding, scar) Transformation zone |
Normal
colposcopic
findings |
Squamous epithelium:
|
Abnormal
colposcopic
findings |
General
principles |
Upper third /lower 2 thirds,
Anterior/posterior/lateral (right or left), |
|
Grade 1
(Minor) |
Thin aceto-white epithelium
Fine punctuation
Fine mosaic |
|
Grade 2
(Major) |
Dense aceto-white epithelium,
Coarse punctuation
Coarse mosaic |
|
Suspicious for
invasion |
Atypical vessels
Additional signs: Fragile vessels, Irregular surface,
Exophytic lesion, Necrosis,
Ulceration (necrotic), tumor/gross neoplasm |
|
Non-specific |
Columnar epithelium (adenosis)
Lesion staining by Lugol's solution (Schiller's test):
Stained/non-stained,
Leukoplakia |
|
Miscellaneous findings |
Erosion (traumatic), condyloma, polyp, cyst,
endometriosis, iinflammation, Vaginal stenosis,
Congenital transformation zone |
¹Bornstein J, Bentley J, Bösze P, Girardi F, Haefner H, Menton M, Perrotta M, Prendiville W, Russell P, Sideri M, Strander B, Torne A, Walker P. 2011 IFCPC colposcopic nomenclature.
Download PDF file
|
