Colposcopy was first described by Hans Hinselman of Germany in 1925. At the time, he hoped this would be an effective screening tool for cervical cancer, one of the most common malignancies to affect women in his era. Hinselman suspected that endophytic or exophytic lesions of the cervix were likely precursors of cervical carcinoma, and he hoped that by magnifying these tissues, precursor lesions might be identified early enough to allow effective treatment before invasive disease developed or spread. His theories on the genesis of cervical cancer were incorrect, and his protocol for colposcopic evaluation was clinically impractical, so the search for alternative methods for cervical cancer screening continued.

By the early 1940s, George Papanicolaou demonstrated the potential of cytologic screening (ie, the Papanicolaou test or Pap smear) as a test for malignant conditions of the cervix. Colposcopy became a competing test with the Pap smear for cervical cancer screening. The Pap smear was quickly demonstrated as superior as a screening test, and it became widely accepted as the first-line modality for this purpose. The colposcope was essentially forgotten until the 1960s, when it was rediscovered as a complementary test for women with abnormal cytologic findings. Currently it has near-universal acceptance as the most effective follow-up test for women suspected of having cervical lesions with malignant potential.

This series of CD-ROMs has been prepared by V. Cecil Wright M.D, a practicing gyn-oncologist, who over several decades has evaluated more than 25,000 new patients in his clinical practice in colposcopy and gynecologic oncology. The clinical information contained within the products is designed to teach and evaluate both existing and trainee colposcopists in their understanding of colposcopy and its closely related subjects, whilst providing supplements to their existing knowledge of the subject with new concepts.

100 CASE COLPOSCOPY CHALLENGE: CERVIX, VAGINA, VULVA & ADJACENT SITES CD-ROM
TEST YOURSELF OR YOUR TRAINEES USING TRUE COLPOPHOTOGRAPHS WITH SOME SUPPORTING CYTOLOGY AND HISTOLOGY

This CD-ROM consists of colpophotographs with some histology and cytology added together with pertinent clinical information needed to make the correct colposcopic diagnosis. This exercise requires a basic knowledge of colposcopic patterns in squamous and glandular diseases of cervix, vagina, vulva and adjacent areas. The cases will test the ability to differentiate between diseases and their colposcopic mimics.
This is useful as a challenge of expertise but can also be considered as case studies in colposcopic practice.

COLOR ATLAS OF COLPOSCOPY: Cervix, Vagina and Vulva

The variety of images examined during cervical colposcopy is endless and sorting them out is endlessly fascinating. Even normal metaplasia, by which glandular epithelium is transformed into squamous epithelium, presents a multitude of appearances. Most colposcopists can interpret blood vessel arrangements and detect acetowhite epithelium. Most can predict the histology in squamous disease using Adolf Stafl’s five criteria (surface contour, color tone, vessel configuration, abruptness of demarcation and intercapillary distance). But glandular lesions are poorly understood by many of even the most experienced colposcopists because they are encountered so rarely and because their features are only now being delineated. The existence of colposcopic mimics, in which completely different histology produces similar or virtually identical colposcopic appearances, complicates the situation. This is why a biopsy is always required on the cervix.
Colposcopic evaluation of the vagina, vulva and adjacent sites presents an entirely different array of features to interpret. Expertise is only achieved by evaluating a large number of cases, either in actual practice or by studying images in print, film, video or electronic form. The author hopes that this work, and particularly the important new material on glandular disease, will contribute to excellence in the contemporary practice of colposcopy.
The information contained in this book is not only intended to introduce new material but also to review established concepts and supplement the knowledge of the practicing colposcopist.

Contents:

• The Colposcope
• Instrumentation and Clinical Set-up
• Steps in the Basic Colposcopic Examination
• The Normal Cervix: Anatomy and Structure
• The Original or Native Squamous Cervical Epithelium
• The Columnar Epithelium
• Metaplasia – The Normal Transformation Zone
• The Abnormal Transformation Zone and Squamous Intraepithelial Neoplasia
• Colposcopy of Cervical Squamous Cell Carcinoma
• Grading the Squamous Colposcopic Lesion
• Colposcopy of Adenocarcinoma In Situ and Adenocarcinoma of the Cervix
• Correlation in Squamous and Glandular Disease
• The Colposcopic Differentiation of Glandular Lesions from Other Cervical Lesions
• Colposcopy of the Cervix in Pregnancy
• Colposcopy of Cervical Condylomata
• Colposcopy of Cervical Polyps and the DES-Exposed
• Colposcopy of the Cervix After Treatment for Squamous Intraepithelial Neoplasia
• Colposcopy of the Vagina
• Colposcopy of the Vulva and Adjacent Sites

FUNDAMENTALS OF COLPOSCOPY CERVIX, VAGINIA AND VULVA
16 LECTURES USING MORE THAN 350 TRUE COLPOPHOTOGRAPHS IN OVER 450 FRAMES OF A POWERPOINT® PRESENTATION ON CD-ROM

Contents:

• Genital Human Papillomavirus (HPV) Infections
• Purpose of Colposcopy and Steps in the Colposcopic Examination
• Normal Cervical Anatomy and Structure
• The Original (Native) Squamous Epithelium of the Cervix
• The Columnar Epithelium of the Cervix
• Metaplasia and the Normal Transformation Zone
• The Abnormal Transformation Zone and its Colposcopic Mimics
• Colposcopy of the Cervix during Pregnancy
• Correlation of Cytology, Colposcopy and Histology - Triaging the Patient
• Colposcopy of Cervical Condylomata
• Colposcopy of Cervical Polyps and Miscellaneous Conditions
• Colposcopy of Glandular Disease
• Using the Transformation Zone in Squamous Disease as a Guide to Treatment
• The Cervix after Treatment: Normal vs Persistence
• Colposcopy of the Vulva
• Colposcopy of the Vagina

PRINCIPLES OF CERVICAL COLPOSCOPY

Contents:

• Instumentation and Clinical Set-up
• Steps in Basic Colposcopic Examination
• The Anatomical Topography and Development Aspects of the Human Cervix
• The Original/Native Squamous Epithelium of the Cervix
• The Original or Native Squamous Cervical Epithelium
• The Columnar Epithelium of the Human Cervix
• Metaplasia and the Normal Transformation Zone
• The Abnormal Transformation Zone – Squamous Intraepithelial Neoplasia and Squamous Cell Carcinoma
• Satisfactory Colposcopy Versus Unsatisfactory Colposcopy and Grading the Squamous Lesion
• Correlation of Cytology, Colposcopy and Histology
• Colposcopy of Cervical Glandular Disease
• Colposcopy of Cervical Condylomata
• Colposcopy of the Cervix in Pregnancy
• Colposcopy of the Cervix in Diethylstilbestrol Exposure
• Colposcopy of Microglandular Hyperplasia
• Colposcopy of Masses Prolapsing from the Uterus
• Colposcopy of the Cervix in Trichomonas and Candida Infections

UNDERSTANDING CERVICAL COLPOSCOPY CD-ROM
BY ANALYSIS OF 240 TRUE COLPOPHOTOGRAPHS
IN A POWERPOINT PRESENTATION

Contents:

• The normal cervix
• Native squamous epithelium
• Columnar epithelium
• Metaplasia - the normal transformation zone
• The abnormal transformation zone - cervical intraepithelial neoplasia
• The abnormal transformation zone - squamous cell cancer
• Glandular lesions - adenocarcinoma in situ and adenocarcinoma
• The cervix in pregnancy
• Cervical condylomata
• Cervical polyps, DES-exposed and other structural abnormalities
• Microglandular hyperplasia
• Inflammatory conditions
• Colposcopy of cervix and vaginal vault after treatment for cervical intraepithelial neoplasia and cancer with “Core Concept” summaries for each topic.

UNDERSTANDING CERVICAL GLANDULAR DISEASE CD-ROM
BY ANALYSIS OF 85 TRUE COLPOPHOTOGRAPHS
IN A POWERPOINT PRESENTATION

Contents:

• Normal and abnormal cervical glandular cytology
• Histology of normal endocervical columnar epithelium
• Histological types of adenocarcinoma in situ/cancer
• Buried disease
• Colposcopic features of normal villous structures
• Colposcopic presentations of adenocarcinoma in situ and adenocarcinoma
• Colposcopic mimics of glandular disease
• Differentiation from squamous disease
• Differentiation of glandular disease from mimics using surface patterns and blood vessel patterns
• Mixed glandular and squamous disease
• AIS within endocervical polyps
• Schematics of characteristic vessel types
• “Core Concept” summaries for main topics.

UNDERSTANDING VULVAR COLPOSCOPY AND ADJACENT SITES
BY ANALYSIS OF 152 TRUE COLPOPHOTOGRAPHS
IN A POWERPOINT PRESENTATION*

Contents:

• The normal vulva
• Vulvar intraepithelial neoplasia
• Squamous cell cancer of the vulva, urethra, perineum, perianal skin, verrucous carcinoma, basal cell carcinoma
• Malignant melanoma and benign nevi
• Viral infections, inflammatory conditions and chemical burns
• Lichen sclerosus and squamous cell hyperplasia
• Lichen planus
• Lichen planum
• Condylomata of vulva, perineum, anal and perianal areas
• Angiomas
• Epidermoid and vestibular cysts
• Hidradenoma papilliferum
• Paget’s disease
• Etcetera, plus supportive histology
• “Core Concept” summaries for main topics.