Dysplasia

Question 1

What is cervical metaplasia?

Answer 1

Normal process, but most susceptible area to HPV
Columnar epithelial replaced by squamous epithelium as vaginal pH increases (with age)

Question 2

What is the T-zone?

Answer 2

Transformation zone between outer squamous epithelium and inner squamocolumnar junction

Question 3

How does 5% acetic acid work?

Answer 3

Shrinks cytoplasm > nuclei more prominent

Question 4

What are punctations?

Answer 4

Preservation of columnar vessels in neoplastic epithelium > normal villi gone

Question 5

What is mosaicism?

Answer 5

CIN fills glands > network of vessels around glands visible

Question 6

How does Lugol’s work?

Answer 6

Who knows? Shows borders of CIN lesions

Question 7

Characteristic appearance of adenocarcinoma

Answer 7

Short branching vessels like ginger root
Friable surface vessels

Question 8

Strategy for positive margins on CKC

Answer 8

Ectocervix: pap, colpo, ecc at 4-6 months
Endocervix: consider repeat excision or hyst, up to 10% risk of cancer on final specimen

Question 9

Definition of invasion in cervical cancer

Answer 9

Into stoma

Question 10

Risk of residual disease and recurrence after positive margins

Answer 10

20% residual disease
5% invasive disease
50% recurrence