Cervical neoplasia and gland openings

Colposcopy for Gland (Crypt) Openings

“…As above-mentioned, the authors [1,3,4] classified the gland openings of the uterine cervix into the following five types for colposcopy, where the surface epithelium suffers from too severe inflammatory or other retrogressive changes to yield any clear colposcopic impressions. Type I Normal gland opening Type II Gland opening surrounded by a narrow white ring Type III Gland opening surrounded by a rather indistinct white ring Type IV Gland opening surrounded by a distinct and mostly thickened white ring (doughnut-like) Type V Solid gland opening Cases with directed biopsies or resected cervices showing CIN or more severe lesions were designated as Bpositive^ [3].…”

“…For colposcopy, the acetowhite epithelium was, therefore, divided into two areas, the endocervical and the ectocervical area [1], or within the transformation zone and outside the transformation zone [2], in accordance with the distribution of gland openings. Furthermore, to some irritating circumstances the cells of the cervical glands do not always react in the same manner as those of the surface.…”

Magnification and Chromoscopy with the Acetic Acid Test

“…Gland or crypt openings on the surface of the cervix will often whiten in a characteristic ªcuffedº pattern ( Figure 1) [5]. A Japanese group [6] went as far as to claim that the colposcopic diagnosis of cervical neoplasia could be aided by the identification of certain patterns of whitening around gland openings. Nevertheless, gland openings provide a channel or conduit for acetic acid to pass the top highly differentiated squamous-cell level and result in the increased surface area of glandular or columnar cells exposed to acetic acid.…”