Secondary Prevention of Cervical Cancer
Colposcopy
Rule 6 - Pathognomonic Colposcopic Signs
Which pathognomonic colposcopic findings are present?
1.
Ridge sign
2.
Rag sign
3.
Cuffed crypt openings
4.
Inner border sign
5.
Ridge sign and Cuffed crypt openings
6.
No pathognomonic sign
The colpophotogram is from a 28-year-old gravida 0 after application of 5% acetic acid showing an atypical transformation zone type 2. Colposcopy reveals an acetowhite lesion between 9 and 2 o’clock and a distinct and conspicuous ridge with high opacity at 12 o’clock close to the squamocolumnar junction reaching into the cervical canal. Several cuffed crypt openings can also be identified. Due to the presence of two pathognomonic signs this lesion is classified as “major change”. Cytology was suggestive of HSIL (CIN 3) and high risk HPV DNA was detected. Histopathologic examination confirmed CIN 3.