ÿþ<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3c.org/TR/1999/REC-html401-19991224/loose.dtd"> <html xmlns="http://www.w3.org/1999/xhtml" xmlns:v="urn:schemas-microsoft-com:vml" xmlns:o="urn:schemas-microsoft-com:office:office" xmlns:(null)0="http://www.w3.org/TR/REC-html40"><head><title>Rocky Mountain OB-GYN .::. Riverton, Wyoming</title> <meta content="text/html; charset=unicode" http-equiv="Content-Type"> <meta name="description" content=""> <meta name="keywords" content=""> <script language="JavaScript" type="text/javascript"> <!-- function clickmail(domain,mailto) { var url = "mailto:" + mailto + "@" + domain; self.location.href = url; return; } //--> </script> <link rel="stylesheet" type="text/css" href="styles.css"> <meta name="GENERATOR" content="Microsoft FrontPage 5.0"> </head> <body> <!-- DHTML Menu Builder Loader Code START --> <div style="POSITION: absolute" id="dmbri"> <img name="dmbif" alt="" src="layout/dmb_i.gif" width="1" height="1"> <img name="dmbjs" alt="" src="layout/dmb_m.gif" width="1" height="1"> </div> <!-- <script type="text/javascript"> var rimPath=null;var rjsPath=null;var rPath2Root=null;function InitRelCode(){var iImg;var jImg;var tObj;if(!document.layers){iImg=document.images['dmbif'];jImg=document.images['dmbjs'];tObj=jImg;}else{tObj=document.layers['dmbri'];if(tObj){iImg=tObj.document.images['dmbif'];jImg=tObj.document.images['dmbjs'];}}if(!tObj){window.setTimeout("InitRelCode()",700);return false;}rimPath=_gp(iImg.src);rjsPath=_gp(jImg.src);rPath2Root=rjsPath+"../";return true;}function _purl(u){return xrep(xrep(u,"%%REP%%",rPath2Root),"\\","/");}function _fip(img){if(img.src.indexOf("%%REL%%")!=-1) img.src=rimPath+img.src.split("%%REL%%")[1];return img.src;}function _gp(p){return p.substr(0,p.lastIndexOf("/")+1);}function xrep(s,f,n){if(s) s=s.split(f).join(n);return s;}InitRelCode(); </script> <script type="text/javascript"> /* <![CDATA[ */function LoadMenus() {if(!rjsPath){window.setTimeout("LoadMenus()", 10);return false;}var navVer = navigator.appVersion; if(navVer.substr(0,3) >= 4) if((navigator.appName=="Netscape") && (parseInt(navigator.appVersion)==4)) { document.write('<' + 'script type="text/javascript" src="' + rjsPath + 'nsmenu.js"><\/script\>'); } else { document.write('<' + 'script type="text/javascript" src="' + rjsPath + 'iemenu.js"><\/script\>'); }return true;}LoadMenus();/* ]]> */</script> DHTML Menu Builder Loader Code END --> <div align="center"> <table border="0" cellspacing="0" cellpadding="0" width="800"> <tbody> <tr> <td height="171" valign="top" width="453" align="left"> <img id="MenuSpacer" name=MenuSpacer alt=MenuSpacer src="layout/spacer.gif" width=413 height=64><img border=0 alt="Rocky Mountain OB-GYN" src="layout/logo.jpg" useMap=#Map align="left" width="339" height="77"><p>&nbsp;&nbsp; </td> <td height="171" valign="top" width="347" align="left" bgcolor="#8DB2CD"> <p align="center"><br> <font face="Verdana" size="5" color="#005591"><br> EVALUATING AN<br> ABNORMAL PAP SMEAR<br> WITH COLPOSCOPY<br> AND BIOPSY</font></td> </tr></tbody></table> <table class="body-table-right-bottom" border="0" cellspacing="0" cellpadding="0" width=800> <tbody> <tr> <td valign="top" background="layout/body-bg-left.jpg" width="8" align="left" bgcolor="#A75F5F"> <img alt="Rocky Mountain OBGYN" src="layout/body-top-left.jpg" width="8" height="27"><img alt="Rocky Mountain OBGYN" src="layout/spacer.gif" width=8 height=400></td> <td class="body-bg" valign="top" colspan="2" align="left"> <table border="0" cellspacing="0" cellpadding="10" width="790"> <tbody> <tr> <td valign="top" align="left" width="427" colspan="3"> <p align="center"><font size="1"><br> <img border="0" src="images/colposcopy.gif" width="300" height="283"></font></td> <td valign="top" width="323" align="left" bgcolor="#C9DAE7"> Evaluation of an abnormal pap smear involves use of an instrument called a COLPOSCOPE, which resembles a set of binoculars mounted on a stand.&nbsp; The health provider views the cervix with the magnification provided by the colposcope after putting a diluted vinegar solution or dye on the cervix to bring out abnormalities.<p> Some colposcopes have a camera attached that allows pictures to be taken (and in some instances, you the patient can also see.)</p> <p>For a printable (PDF) document about colposcopy, <a target="_blank" href="http://www.asccp.org/pdfs/patient_edu/colposcopy_20090416.pdf"> click on this link</a> to The American Society for Colposcopy and Cervical Pathology (ASCCP.org)</td></tr> <tr> <td valign="top" align="left" width="427" colspan="3"> <p align="center"> <img border="0" src="images/colpo%20vu1.jpg" width="422" height="313"></td> <td valign="top" width="323" align="left"> Here is an example of a magnified view through the colposcope.&nbsp; The darker, linear area at the top of the picture is the opening into the cervix (the cervical os) and the abnormal area is represented by the slightly more whitish tissue in the central area, with an irregular border.<p>Most of this cervix has squamous or skin cells on the exterior, with a small amount of glandular tissue near the cercvical os.&nbsp; The abnormal area's boundary was likely the original transformation zone.&nbsp; The changes in the abnormal area, a somewhat mosaic pattern, are due to HPV effect in the cervical tissues.</p> <p>These features are seen after application of the vinegar solution.</td></tr> <tr> <td valign="top" align="left" width="427" colspan="3"> <p align="center"> <img border="0" src="images/biopsy%20punch.jpg" width="225" height="235"></td> <td valign="top" width="323" align="left" bgcolor="#C9DAE7"> After identifying areas of abnormality, the health provider usually takes a biopsy, a small piece of tissue, with a special instrument called a biopsy forceps.&nbsp; An example of one is shown on the left.<p>Don't worry -- the tip of this one is also magnified.&nbsp; The typical biopsy taken is about the same size as the letter &quot;O&quot; as seen on your screen.&nbsp; Most patients will feel only a minor pinching sensation when the biopsy is taken.</td></tr> <tr> <td valign="top" align="left" width="375"> <p align="center"><img border="0" src="images/path2.jpg" width="275" height="207"></td> <td valign="top" align="left" width="375" colspan="3"> The tissue biopsy is then sent to a pathology lab for staining, and then read under a microscope.&nbsp; It may take several days before a report is returned to your health provider.&nbsp; At the left is a photo-micrograph of a small biopsy of the cervix.&nbsp; The skin tissue is the purplish tissue above the more horizontal pinkish tissue below it.&nbsp; In this biopsy, there are abnormal cells arising from the bottom of the skin layer (note the variation in cell size and nucleus) which persist in the flattened out portion of the topmost layer.&nbsp; These will show up on Pap smear.</td> </tr> <tr> <td valign="top" align="center" width="375" colspan="2"> <a target="_blank" href="http://www.acog.org/publications/patient_education/bp135.cfm">ACOG Information on Colposcopy</a>&nbsp;&nbsp; <a target="_blank" href="http://www.acog.org/publications/patient_education/sp135.cfm">(Spanish Version)</a></td> <td valign="top" align="center" width="375" colspan="2"> <font face="Arial" size="4"><a href="next-steps.htm">NEXT STEPS IN TREATMENT</a></font><p><font face="Arial" size="4"> <a href="pap-central.htm">Return to Pap Smear Central</a></font></td> </tr> </tbody></table></td></tr></tbody></table> <table border="0" cellspacing="0" cellpadding="0" width="798"> <tbody> <tr> <td colspan="3" align="middle"><br><br><a href="./"><span class=footer-links>HOME</span></a> &nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; 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