Albert Singer, Ashfaq Khan
Singer and Monaghan's Cervical and Lower Genital Tract Precancer (eBook, PDF)
Diagnosis and Treatment
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Albert Singer, Ashfaq Khan
Singer and Monaghan's Cervical and Lower Genital Tract Precancer (eBook, PDF)
Diagnosis and Treatment
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The guide to effective practice management of precancerous lesions in cervix and lower genital tract. This third edition contains in-depth examination of the different modalities that contribute to the safe and scientific management of precancerous lesions in the female genital tract. One of the most important is colposcopy which provides an accurate and effective route to their identification. Professor Albert Singer is internationally recognized as a master of colposcopy. His training courses throughout the world are in high demand. In this edition, he has teamed with fellow expert Ashfaq…mehr
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The guide to effective practice management of precancerous lesions in cervix and lower genital tract. This third edition contains in-depth examination of the different modalities that contribute to the safe and scientific management of precancerous lesions in the female genital tract. One of the most important is colposcopy which provides an accurate and effective route to their identification. Professor Albert Singer is internationally recognized as a master of colposcopy. His training courses throughout the world are in high demand. In this edition, he has teamed with fellow expert Ashfaq Khan to present a very accessible, authoritative and highly illustrated guide to the power of colposcopy. Practical pictorial guidance to recognizing potentially cancerous abnormalities in the cervix, vagina, and vulva is framed by internationally agreed disease classifications. Consensus guidelines from the US and Europe provide a rigorous platform for management advice. The latest information on HPV, the role of biomarkers, and new methods in diagnosis and treatment are all featured. Cervical and Lower Genital Tract Precancer is the ideal companion for anyone wishing to incorporate safe and scientific methods of diagnosis and treatment into their clinical practice.
Produktdetails
- Produktdetails
- Verlag: John Wiley & Sons
- Seitenzahl: 304
- Erscheinungstermin: 30. April 2014
- Englisch
- ISBN-13: 9781118800850
- Artikelnr.: 41053090
- Verlag: John Wiley & Sons
- Seitenzahl: 304
- Erscheinungstermin: 30. April 2014
- Englisch
- ISBN-13: 9781118800850
- Artikelnr.: 41053090
ALBERT SINGER, MB BS, PhD DPhil, FRCOG, Emeritus Professor of Gynecology and Consultant in Obstetrics and Gynecology, Whittington Hospital, London, UK; and Quality Assurance lead for colposcopy in London. ASHFAQ KHAN, MB BS, FRCOG, Consultant Gynecologist at the Whittington Hospital, London, UK.
1 The Histopathology of Lower Genital Tract Neoplasia 2 Human Papillomaviruses in Pathogenesis of Lower Genital Tract Neoplasia 3 Examination for Cervical Precancer--Use of colposcopy 4 Colposcopy of the Normal Cervix--A prerequisite to establish the diagnosis of cervical cancer 5 Cytology and Screening for Cervical Precancer 6 Diagnosis of Cervical Precancer--The use of colposcopy 7 Management of Cervical Precancer 8 Vaginal Intraepithelial Neoplasia 9 Vulvar Intraepithelial Neoplasia 10 Perianal and Anal Intraepithelial Neoplasia 11 Genital Tract Adenosis 12 Infective and Other Conditions Causing Confusion in Diagnosis of Lower Genital Tract Precancer
Preface to the Third Edition
ix Preface to the First Edition
x Acknowledgements
xi 1 The Histopathology of Lower Genital Tract Neoplasia
1 1.1 Introduction
1 1.2 Terminology
1 1.3 Histopathologic features of cervical intraepithelial neoplasia or squamous intraepithelial lesion
3 1.4 Cervical glandular intraepithelial neoplasia and adenocarcinoma in situ
6 1.5 Early invasive carcinoma
7 1.6 Vaginal intraepithelial neoplasia
11 1.7 Vulval precancer
11 1.8 Related topics
12 1.9 Further reading
13 2 Human Papillomaviruses in the Pathogenesis of Lower Genital Tract Neoplasia
14 2.1 Introduction
14 2.2 Characteristics of human papillomaviruses
14 2.3 Manifestations of genital human papillomavirus infections
15 2.4 Prevalence of genital human papillomavirus infections
18 2.5 Transmission of genital human papillomavirus infections
19 2.6 Risk factors for genital human papillomavirus infections
19 2.7 Natural history of cervical human papillomavirus infections
19 2.8 Molecular pathways of human papillomavirus oncogenesis
19 2.9 The effect of human papillomavirus/host cell interaction: a prerequisite for neoplasia
21 2.10 The role of oncogenic human papillomavirus detection in the prevention of lower genital tract precancer
22 2.11 Further reading
23 3 Examination for Cervical Precancer: Use of colposcopy
24 3.1 Introduction
24 3.2 Tissue basis for colposcopy
24 3.3 The colposcopic examination
25 3.4 Video colposcopy
31 3.5 Image and electronic data management
31 3.6 Further reading
32 4 Colposcopy of the Normal Cervix: A prerequisite to establishing the diagnosis of cervical precancer
33 4.1 Introduction
33 4.2 Cervical epithelium: natural history
33 4.3 Cervical epithelium: topography
34 4.4 Cervical epithelium: colposcopic appearances
35 4.5 Squamous metaplastic epithelium
38 4.6 Colposcopy of the adolescent cervix
44 4.7 Cervical epithelium during pregnancy and puerperium
46 4.8 The effect of vaginal delivery on the cervical epithelium
48 4.9 The cervical epithelium during the menopause
50 4.10 The oral contraceptives and their effect on the cervix
52 4.11 The congenital transformation zone
53 4.12 Further reading
58 5 Cytology and Screening for Cervical Precancer
59 5.1 Introduction
59 5.2 Cytologic classifications
59 5.3 Cytologic reporting
60 5.4 Clinical referral
63 5.5 Cytodiagnosis of cervical glandular intraepithelial neoplasia/adenocarcinoma in situ
66 5.6 Cytologic features of adenocarcinoma
68 5.7 Screening for cervical cancer
68 5.8 Improvements to cervical screening
70 5.9 Cytologic interpretation
72 5.10 Role of human papillomavirus testing in the UK NHS Cervical Screening Programme
72 5.11 Primary screening with human papillomavirus testing
73 5.12 Human papillomavirus test as follow-up after treatment of cervical intraepithelial neoplasia
74 5.13 Human papillomavirus testing to triage minor cytologic lesions
74 5.14 Role of type-specific human papillomavirus tests
74 5.15 Further reading
75 6 Diagnosis of Cervical Precancer: Use of colposcopy
76 6.1 Introduction
76 6.2 Which cytologic abnormalities need further investigation?
76 6.3 Colposcopy: the initial clinical examination
76 6.4 The rationale for the use of colposcopy in the diagnosis of cervical precancer
77 6.5 Colposcopic appearance of the abnormal (atypical) cervical epithelium
78 6.6 The classification of colposcopically abnormal (atypical) cervical epithelium
87 6.7 Colposcopic examination of the precancerous/cancerous cervix
88 6.8 Benign condyloma of cervix
104 6.9 Correlation of diagnostic methods in the detection of cervical squamous precancer
111 6.10 Lack of correlation between diagnostic methods
116 6.11 The diagnosis of early invasion
117 6.12 Preclinical invasive carcinoma (colposcopically overt/suspect): colposcopy and pathology
122 6.13 Precancerous glandular lesions of the cervix
125 6.14 Colposcopic diagnosis of early adenocarcinoma of the cervix
128 6.15 Further reading
135 7 Management of Cervical Precancer
136 7.1 Introduction
136 7.2 Rationale behind treatment
136 7.3 Colposcopic and pathologic characteristics of cervical intraepithelial neoplasia lesions: a prerequisite to treatment
136 7.4 Colposcopically directed biopsy
139 7.5 How to manage abnormal cytology?
140 7.6 Which lesions to treat
143 7.7 Prerequisites for treatment
144 7.8 Methods of treatment
145 7.9 Excision techniques for treating cervical intraepithelial neoplasia
153 7.10 Management of extension of the abnormal (atypical) transformation zone
163 7.11 Hysterectomy in the treatment of cervical intraepithelial neoplasia
166 7.12 Immediate complications of cervical intraepithelial neoplasia treatment
166 7.13 Long-term complications of cervical intraepithelial neoplasia treatment
168 7.14 Follow-up after treatment of cervical intraepithelial neoplasia
171 7.15 Treatment of suspected recurrence
174 7.16 Precancer in pregnancy
174 7.17 Precancer in the HIV-positive patient
178 7.18 Management of early invasive squamous carcinoma of the cervix (FIGO stage I)
180 7.19 Further reading
184 8 Vaginal Intraepithelial Neoplasia
185 8.1 Introduction
185 8.2 Natural history of vaginal intraepithelial neoplasia
185 8.3 Etiology
186 8.4 Clinical presentation
186 8.5 Vaginal intraepithelial neoplasia following hysterectomy
189 8.6 Biopsy of the vaginal intraepithelial neoplasia lesion
191 8.7 Pathology of vaginal intraepithelial neoplasia: is it a precancerous lesion?
193 8.8 Vaginal precancer and cancer: part of the lower genital tract neoplastic syndrome
194 8.9 Treatment of vaginal intraepithelial neoplasia
199 8.10 Further reading
204 9 Vulval Intraepithelial Neoplasia
205 9.1 Introduction
205 9.2 Epidemiology and pathogenesis
205 9.3 Natural history of vulval intraepithelial neoplasia: the rationale for treatment?
207 9.4 Pathology
209 9.5 The clinical examination in general
211 9.6 The clinical examination (specific)
215 9.7 Vulval intraepithelial neoplasia affecting the pilosebaceous unit
222 9.8 Superficially invasive carcinoma of the vulva
223 9.9 Lichen sclerosus
228 9.10 Paget's disease (non-squamous intraepithelial neoplasia)
230 9.11 Vulval lesions masquerading as cancer or precancer
231 9.12 Skin and accessory appendages that are important for the management of vulval intraepithelial neoplasia
237 9.13 Management of vulval intraepithelial neoplasia
239 9.14 Treatment of superficial invasive vulval carcinoma
254 9.15 Further reading
255 10 Perianal and Anal Intraepithelial Neoplasia
256 10.1 Epidemiology
256 10.2 Etiology
256 10.3 Association with other genital intraepithelial neoplastic diseases
257 10.4 Examination
257 10.5 Presentation
258 10.6 Lesions masquerading as intraepithelial neoplasia
260 10.7 Anal canal involvement
261 10.8 Management and treatment
262 10.9 Further reading
267 11 Genital Tract Adenosis
268 11.1 Introduction
268 11.2 Developmental anatomy
268 11.3 Developmental anomalies caused by diethylstilbestrol
269 11.4 Present situation
272 11.5 Further reading
272 12 Infective and Other Conditions Causing Confusion in Diagnosis of Lower Genital Tract Precancer
273 12.1 Introduction
273 12.2 Trichomonas vaginalis
273 12.3 Bacterial vaginosis
273 12.4 Candidiasis
274 12.5 Herpes genitalis infection
275 12.6 Human papillomavirus infection
279 12.7 Cervical deciduosis in pregnancy
280 12.8 Polypoid lesions of the cervix
282 12.9 Further reading
285 Index
287
ix Preface to the First Edition
x Acknowledgements
xi 1 The Histopathology of Lower Genital Tract Neoplasia
1 1.1 Introduction
1 1.2 Terminology
1 1.3 Histopathologic features of cervical intraepithelial neoplasia or squamous intraepithelial lesion
3 1.4 Cervical glandular intraepithelial neoplasia and adenocarcinoma in situ
6 1.5 Early invasive carcinoma
7 1.6 Vaginal intraepithelial neoplasia
11 1.7 Vulval precancer
11 1.8 Related topics
12 1.9 Further reading
13 2 Human Papillomaviruses in the Pathogenesis of Lower Genital Tract Neoplasia
14 2.1 Introduction
14 2.2 Characteristics of human papillomaviruses
14 2.3 Manifestations of genital human papillomavirus infections
15 2.4 Prevalence of genital human papillomavirus infections
18 2.5 Transmission of genital human papillomavirus infections
19 2.6 Risk factors for genital human papillomavirus infections
19 2.7 Natural history of cervical human papillomavirus infections
19 2.8 Molecular pathways of human papillomavirus oncogenesis
19 2.9 The effect of human papillomavirus/host cell interaction: a prerequisite for neoplasia
21 2.10 The role of oncogenic human papillomavirus detection in the prevention of lower genital tract precancer
22 2.11 Further reading
23 3 Examination for Cervical Precancer: Use of colposcopy
24 3.1 Introduction
24 3.2 Tissue basis for colposcopy
24 3.3 The colposcopic examination
25 3.4 Video colposcopy
31 3.5 Image and electronic data management
31 3.6 Further reading
32 4 Colposcopy of the Normal Cervix: A prerequisite to establishing the diagnosis of cervical precancer
33 4.1 Introduction
33 4.2 Cervical epithelium: natural history
33 4.3 Cervical epithelium: topography
34 4.4 Cervical epithelium: colposcopic appearances
35 4.5 Squamous metaplastic epithelium
38 4.6 Colposcopy of the adolescent cervix
44 4.7 Cervical epithelium during pregnancy and puerperium
46 4.8 The effect of vaginal delivery on the cervical epithelium
48 4.9 The cervical epithelium during the menopause
50 4.10 The oral contraceptives and their effect on the cervix
52 4.11 The congenital transformation zone
53 4.12 Further reading
58 5 Cytology and Screening for Cervical Precancer
59 5.1 Introduction
59 5.2 Cytologic classifications
59 5.3 Cytologic reporting
60 5.4 Clinical referral
63 5.5 Cytodiagnosis of cervical glandular intraepithelial neoplasia/adenocarcinoma in situ
66 5.6 Cytologic features of adenocarcinoma
68 5.7 Screening for cervical cancer
68 5.8 Improvements to cervical screening
70 5.9 Cytologic interpretation
72 5.10 Role of human papillomavirus testing in the UK NHS Cervical Screening Programme
72 5.11 Primary screening with human papillomavirus testing
73 5.12 Human papillomavirus test as follow-up after treatment of cervical intraepithelial neoplasia
74 5.13 Human papillomavirus testing to triage minor cytologic lesions
74 5.14 Role of type-specific human papillomavirus tests
74 5.15 Further reading
75 6 Diagnosis of Cervical Precancer: Use of colposcopy
76 6.1 Introduction
76 6.2 Which cytologic abnormalities need further investigation?
76 6.3 Colposcopy: the initial clinical examination
76 6.4 The rationale for the use of colposcopy in the diagnosis of cervical precancer
77 6.5 Colposcopic appearance of the abnormal (atypical) cervical epithelium
78 6.6 The classification of colposcopically abnormal (atypical) cervical epithelium
87 6.7 Colposcopic examination of the precancerous/cancerous cervix
88 6.8 Benign condyloma of cervix
104 6.9 Correlation of diagnostic methods in the detection of cervical squamous precancer
111 6.10 Lack of correlation between diagnostic methods
116 6.11 The diagnosis of early invasion
117 6.12 Preclinical invasive carcinoma (colposcopically overt/suspect): colposcopy and pathology
122 6.13 Precancerous glandular lesions of the cervix
125 6.14 Colposcopic diagnosis of early adenocarcinoma of the cervix
128 6.15 Further reading
135 7 Management of Cervical Precancer
136 7.1 Introduction
136 7.2 Rationale behind treatment
136 7.3 Colposcopic and pathologic characteristics of cervical intraepithelial neoplasia lesions: a prerequisite to treatment
136 7.4 Colposcopically directed biopsy
139 7.5 How to manage abnormal cytology?
140 7.6 Which lesions to treat
143 7.7 Prerequisites for treatment
144 7.8 Methods of treatment
145 7.9 Excision techniques for treating cervical intraepithelial neoplasia
153 7.10 Management of extension of the abnormal (atypical) transformation zone
163 7.11 Hysterectomy in the treatment of cervical intraepithelial neoplasia
166 7.12 Immediate complications of cervical intraepithelial neoplasia treatment
166 7.13 Long-term complications of cervical intraepithelial neoplasia treatment
168 7.14 Follow-up after treatment of cervical intraepithelial neoplasia
171 7.15 Treatment of suspected recurrence
174 7.16 Precancer in pregnancy
174 7.17 Precancer in the HIV-positive patient
178 7.18 Management of early invasive squamous carcinoma of the cervix (FIGO stage I)
180 7.19 Further reading
184 8 Vaginal Intraepithelial Neoplasia
185 8.1 Introduction
185 8.2 Natural history of vaginal intraepithelial neoplasia
185 8.3 Etiology
186 8.4 Clinical presentation
186 8.5 Vaginal intraepithelial neoplasia following hysterectomy
189 8.6 Biopsy of the vaginal intraepithelial neoplasia lesion
191 8.7 Pathology of vaginal intraepithelial neoplasia: is it a precancerous lesion?
193 8.8 Vaginal precancer and cancer: part of the lower genital tract neoplastic syndrome
194 8.9 Treatment of vaginal intraepithelial neoplasia
199 8.10 Further reading
204 9 Vulval Intraepithelial Neoplasia
205 9.1 Introduction
205 9.2 Epidemiology and pathogenesis
205 9.3 Natural history of vulval intraepithelial neoplasia: the rationale for treatment?
207 9.4 Pathology
209 9.5 The clinical examination in general
211 9.6 The clinical examination (specific)
215 9.7 Vulval intraepithelial neoplasia affecting the pilosebaceous unit
222 9.8 Superficially invasive carcinoma of the vulva
223 9.9 Lichen sclerosus
228 9.10 Paget's disease (non-squamous intraepithelial neoplasia)
230 9.11 Vulval lesions masquerading as cancer or precancer
231 9.12 Skin and accessory appendages that are important for the management of vulval intraepithelial neoplasia
237 9.13 Management of vulval intraepithelial neoplasia
239 9.14 Treatment of superficial invasive vulval carcinoma
254 9.15 Further reading
255 10 Perianal and Anal Intraepithelial Neoplasia
256 10.1 Epidemiology
256 10.2 Etiology
256 10.3 Association with other genital intraepithelial neoplastic diseases
257 10.4 Examination
257 10.5 Presentation
258 10.6 Lesions masquerading as intraepithelial neoplasia
260 10.7 Anal canal involvement
261 10.8 Management and treatment
262 10.9 Further reading
267 11 Genital Tract Adenosis
268 11.1 Introduction
268 11.2 Developmental anatomy
268 11.3 Developmental anomalies caused by diethylstilbestrol
269 11.4 Present situation
272 11.5 Further reading
272 12 Infective and Other Conditions Causing Confusion in Diagnosis of Lower Genital Tract Precancer
273 12.1 Introduction
273 12.2 Trichomonas vaginalis
273 12.3 Bacterial vaginosis
273 12.4 Candidiasis
274 12.5 Herpes genitalis infection
275 12.6 Human papillomavirus infection
279 12.7 Cervical deciduosis in pregnancy
280 12.8 Polypoid lesions of the cervix
282 12.9 Further reading
285 Index
287
1 The Histopathology of Lower Genital Tract Neoplasia 2 Human Papillomaviruses in Pathogenesis of Lower Genital Tract Neoplasia 3 Examination for Cervical Precancer--Use of colposcopy 4 Colposcopy of the Normal Cervix--A prerequisite to establish the diagnosis of cervical cancer 5 Cytology and Screening for Cervical Precancer 6 Diagnosis of Cervical Precancer--The use of colposcopy 7 Management of Cervical Precancer 8 Vaginal Intraepithelial Neoplasia 9 Vulvar Intraepithelial Neoplasia 10 Perianal and Anal Intraepithelial Neoplasia 11 Genital Tract Adenosis 12 Infective and Other Conditions Causing Confusion in Diagnosis of Lower Genital Tract Precancer
Preface to the Third Edition
ix Preface to the First Edition
x Acknowledgements
xi 1 The Histopathology of Lower Genital Tract Neoplasia
1 1.1 Introduction
1 1.2 Terminology
1 1.3 Histopathologic features of cervical intraepithelial neoplasia or squamous intraepithelial lesion
3 1.4 Cervical glandular intraepithelial neoplasia and adenocarcinoma in situ
6 1.5 Early invasive carcinoma
7 1.6 Vaginal intraepithelial neoplasia
11 1.7 Vulval precancer
11 1.8 Related topics
12 1.9 Further reading
13 2 Human Papillomaviruses in the Pathogenesis of Lower Genital Tract Neoplasia
14 2.1 Introduction
14 2.2 Characteristics of human papillomaviruses
14 2.3 Manifestations of genital human papillomavirus infections
15 2.4 Prevalence of genital human papillomavirus infections
18 2.5 Transmission of genital human papillomavirus infections
19 2.6 Risk factors for genital human papillomavirus infections
19 2.7 Natural history of cervical human papillomavirus infections
19 2.8 Molecular pathways of human papillomavirus oncogenesis
19 2.9 The effect of human papillomavirus/host cell interaction: a prerequisite for neoplasia
21 2.10 The role of oncogenic human papillomavirus detection in the prevention of lower genital tract precancer
22 2.11 Further reading
23 3 Examination for Cervical Precancer: Use of colposcopy
24 3.1 Introduction
24 3.2 Tissue basis for colposcopy
24 3.3 The colposcopic examination
25 3.4 Video colposcopy
31 3.5 Image and electronic data management
31 3.6 Further reading
32 4 Colposcopy of the Normal Cervix: A prerequisite to establishing the diagnosis of cervical precancer
33 4.1 Introduction
33 4.2 Cervical epithelium: natural history
33 4.3 Cervical epithelium: topography
34 4.4 Cervical epithelium: colposcopic appearances
35 4.5 Squamous metaplastic epithelium
38 4.6 Colposcopy of the adolescent cervix
44 4.7 Cervical epithelium during pregnancy and puerperium
46 4.8 The effect of vaginal delivery on the cervical epithelium
48 4.9 The cervical epithelium during the menopause
50 4.10 The oral contraceptives and their effect on the cervix
52 4.11 The congenital transformation zone
53 4.12 Further reading
58 5 Cytology and Screening for Cervical Precancer
59 5.1 Introduction
59 5.2 Cytologic classifications
59 5.3 Cytologic reporting
60 5.4 Clinical referral
63 5.5 Cytodiagnosis of cervical glandular intraepithelial neoplasia/adenocarcinoma in situ
66 5.6 Cytologic features of adenocarcinoma
68 5.7 Screening for cervical cancer
68 5.8 Improvements to cervical screening
70 5.9 Cytologic interpretation
72 5.10 Role of human papillomavirus testing in the UK NHS Cervical Screening Programme
72 5.11 Primary screening with human papillomavirus testing
73 5.12 Human papillomavirus test as follow-up after treatment of cervical intraepithelial neoplasia
74 5.13 Human papillomavirus testing to triage minor cytologic lesions
74 5.14 Role of type-specific human papillomavirus tests
74 5.15 Further reading
75 6 Diagnosis of Cervical Precancer: Use of colposcopy
76 6.1 Introduction
76 6.2 Which cytologic abnormalities need further investigation?
76 6.3 Colposcopy: the initial clinical examination
76 6.4 The rationale for the use of colposcopy in the diagnosis of cervical precancer
77 6.5 Colposcopic appearance of the abnormal (atypical) cervical epithelium
78 6.6 The classification of colposcopically abnormal (atypical) cervical epithelium
87 6.7 Colposcopic examination of the precancerous/cancerous cervix
88 6.8 Benign condyloma of cervix
104 6.9 Correlation of diagnostic methods in the detection of cervical squamous precancer
111 6.10 Lack of correlation between diagnostic methods
116 6.11 The diagnosis of early invasion
117 6.12 Preclinical invasive carcinoma (colposcopically overt/suspect): colposcopy and pathology
122 6.13 Precancerous glandular lesions of the cervix
125 6.14 Colposcopic diagnosis of early adenocarcinoma of the cervix
128 6.15 Further reading
135 7 Management of Cervical Precancer
136 7.1 Introduction
136 7.2 Rationale behind treatment
136 7.3 Colposcopic and pathologic characteristics of cervical intraepithelial neoplasia lesions: a prerequisite to treatment
136 7.4 Colposcopically directed biopsy
139 7.5 How to manage abnormal cytology?
140 7.6 Which lesions to treat
143 7.7 Prerequisites for treatment
144 7.8 Methods of treatment
145 7.9 Excision techniques for treating cervical intraepithelial neoplasia
153 7.10 Management of extension of the abnormal (atypical) transformation zone
163 7.11 Hysterectomy in the treatment of cervical intraepithelial neoplasia
166 7.12 Immediate complications of cervical intraepithelial neoplasia treatment
166 7.13 Long-term complications of cervical intraepithelial neoplasia treatment
168 7.14 Follow-up after treatment of cervical intraepithelial neoplasia
171 7.15 Treatment of suspected recurrence
174 7.16 Precancer in pregnancy
174 7.17 Precancer in the HIV-positive patient
178 7.18 Management of early invasive squamous carcinoma of the cervix (FIGO stage I)
180 7.19 Further reading
184 8 Vaginal Intraepithelial Neoplasia
185 8.1 Introduction
185 8.2 Natural history of vaginal intraepithelial neoplasia
185 8.3 Etiology
186 8.4 Clinical presentation
186 8.5 Vaginal intraepithelial neoplasia following hysterectomy
189 8.6 Biopsy of the vaginal intraepithelial neoplasia lesion
191 8.7 Pathology of vaginal intraepithelial neoplasia: is it a precancerous lesion?
193 8.8 Vaginal precancer and cancer: part of the lower genital tract neoplastic syndrome
194 8.9 Treatment of vaginal intraepithelial neoplasia
199 8.10 Further reading
204 9 Vulval Intraepithelial Neoplasia
205 9.1 Introduction
205 9.2 Epidemiology and pathogenesis
205 9.3 Natural history of vulval intraepithelial neoplasia: the rationale for treatment?
207 9.4 Pathology
209 9.5 The clinical examination in general
211 9.6 The clinical examination (specific)
215 9.7 Vulval intraepithelial neoplasia affecting the pilosebaceous unit
222 9.8 Superficially invasive carcinoma of the vulva
223 9.9 Lichen sclerosus
228 9.10 Paget's disease (non-squamous intraepithelial neoplasia)
230 9.11 Vulval lesions masquerading as cancer or precancer
231 9.12 Skin and accessory appendages that are important for the management of vulval intraepithelial neoplasia
237 9.13 Management of vulval intraepithelial neoplasia
239 9.14 Treatment of superficial invasive vulval carcinoma
254 9.15 Further reading
255 10 Perianal and Anal Intraepithelial Neoplasia
256 10.1 Epidemiology
256 10.2 Etiology
256 10.3 Association with other genital intraepithelial neoplastic diseases
257 10.4 Examination
257 10.5 Presentation
258 10.6 Lesions masquerading as intraepithelial neoplasia
260 10.7 Anal canal involvement
261 10.8 Management and treatment
262 10.9 Further reading
267 11 Genital Tract Adenosis
268 11.1 Introduction
268 11.2 Developmental anatomy
268 11.3 Developmental anomalies caused by diethylstilbestrol
269 11.4 Present situation
272 11.5 Further reading
272 12 Infective and Other Conditions Causing Confusion in Diagnosis of Lower Genital Tract Precancer
273 12.1 Introduction
273 12.2 Trichomonas vaginalis
273 12.3 Bacterial vaginosis
273 12.4 Candidiasis
274 12.5 Herpes genitalis infection
275 12.6 Human papillomavirus infection
279 12.7 Cervical deciduosis in pregnancy
280 12.8 Polypoid lesions of the cervix
282 12.9 Further reading
285 Index
287
ix Preface to the First Edition
x Acknowledgements
xi 1 The Histopathology of Lower Genital Tract Neoplasia
1 1.1 Introduction
1 1.2 Terminology
1 1.3 Histopathologic features of cervical intraepithelial neoplasia or squamous intraepithelial lesion
3 1.4 Cervical glandular intraepithelial neoplasia and adenocarcinoma in situ
6 1.5 Early invasive carcinoma
7 1.6 Vaginal intraepithelial neoplasia
11 1.7 Vulval precancer
11 1.8 Related topics
12 1.9 Further reading
13 2 Human Papillomaviruses in the Pathogenesis of Lower Genital Tract Neoplasia
14 2.1 Introduction
14 2.2 Characteristics of human papillomaviruses
14 2.3 Manifestations of genital human papillomavirus infections
15 2.4 Prevalence of genital human papillomavirus infections
18 2.5 Transmission of genital human papillomavirus infections
19 2.6 Risk factors for genital human papillomavirus infections
19 2.7 Natural history of cervical human papillomavirus infections
19 2.8 Molecular pathways of human papillomavirus oncogenesis
19 2.9 The effect of human papillomavirus/host cell interaction: a prerequisite for neoplasia
21 2.10 The role of oncogenic human papillomavirus detection in the prevention of lower genital tract precancer
22 2.11 Further reading
23 3 Examination for Cervical Precancer: Use of colposcopy
24 3.1 Introduction
24 3.2 Tissue basis for colposcopy
24 3.3 The colposcopic examination
25 3.4 Video colposcopy
31 3.5 Image and electronic data management
31 3.6 Further reading
32 4 Colposcopy of the Normal Cervix: A prerequisite to establishing the diagnosis of cervical precancer
33 4.1 Introduction
33 4.2 Cervical epithelium: natural history
33 4.3 Cervical epithelium: topography
34 4.4 Cervical epithelium: colposcopic appearances
35 4.5 Squamous metaplastic epithelium
38 4.6 Colposcopy of the adolescent cervix
44 4.7 Cervical epithelium during pregnancy and puerperium
46 4.8 The effect of vaginal delivery on the cervical epithelium
48 4.9 The cervical epithelium during the menopause
50 4.10 The oral contraceptives and their effect on the cervix
52 4.11 The congenital transformation zone
53 4.12 Further reading
58 5 Cytology and Screening for Cervical Precancer
59 5.1 Introduction
59 5.2 Cytologic classifications
59 5.3 Cytologic reporting
60 5.4 Clinical referral
63 5.5 Cytodiagnosis of cervical glandular intraepithelial neoplasia/adenocarcinoma in situ
66 5.6 Cytologic features of adenocarcinoma
68 5.7 Screening for cervical cancer
68 5.8 Improvements to cervical screening
70 5.9 Cytologic interpretation
72 5.10 Role of human papillomavirus testing in the UK NHS Cervical Screening Programme
72 5.11 Primary screening with human papillomavirus testing
73 5.12 Human papillomavirus test as follow-up after treatment of cervical intraepithelial neoplasia
74 5.13 Human papillomavirus testing to triage minor cytologic lesions
74 5.14 Role of type-specific human papillomavirus tests
74 5.15 Further reading
75 6 Diagnosis of Cervical Precancer: Use of colposcopy
76 6.1 Introduction
76 6.2 Which cytologic abnormalities need further investigation?
76 6.3 Colposcopy: the initial clinical examination
76 6.4 The rationale for the use of colposcopy in the diagnosis of cervical precancer
77 6.5 Colposcopic appearance of the abnormal (atypical) cervical epithelium
78 6.6 The classification of colposcopically abnormal (atypical) cervical epithelium
87 6.7 Colposcopic examination of the precancerous/cancerous cervix
88 6.8 Benign condyloma of cervix
104 6.9 Correlation of diagnostic methods in the detection of cervical squamous precancer
111 6.10 Lack of correlation between diagnostic methods
116 6.11 The diagnosis of early invasion
117 6.12 Preclinical invasive carcinoma (colposcopically overt/suspect): colposcopy and pathology
122 6.13 Precancerous glandular lesions of the cervix
125 6.14 Colposcopic diagnosis of early adenocarcinoma of the cervix
128 6.15 Further reading
135 7 Management of Cervical Precancer
136 7.1 Introduction
136 7.2 Rationale behind treatment
136 7.3 Colposcopic and pathologic characteristics of cervical intraepithelial neoplasia lesions: a prerequisite to treatment
136 7.4 Colposcopically directed biopsy
139 7.5 How to manage abnormal cytology?
140 7.6 Which lesions to treat
143 7.7 Prerequisites for treatment
144 7.8 Methods of treatment
145 7.9 Excision techniques for treating cervical intraepithelial neoplasia
153 7.10 Management of extension of the abnormal (atypical) transformation zone
163 7.11 Hysterectomy in the treatment of cervical intraepithelial neoplasia
166 7.12 Immediate complications of cervical intraepithelial neoplasia treatment
166 7.13 Long-term complications of cervical intraepithelial neoplasia treatment
168 7.14 Follow-up after treatment of cervical intraepithelial neoplasia
171 7.15 Treatment of suspected recurrence
174 7.16 Precancer in pregnancy
174 7.17 Precancer in the HIV-positive patient
178 7.18 Management of early invasive squamous carcinoma of the cervix (FIGO stage I)
180 7.19 Further reading
184 8 Vaginal Intraepithelial Neoplasia
185 8.1 Introduction
185 8.2 Natural history of vaginal intraepithelial neoplasia
185 8.3 Etiology
186 8.4 Clinical presentation
186 8.5 Vaginal intraepithelial neoplasia following hysterectomy
189 8.6 Biopsy of the vaginal intraepithelial neoplasia lesion
191 8.7 Pathology of vaginal intraepithelial neoplasia: is it a precancerous lesion?
193 8.8 Vaginal precancer and cancer: part of the lower genital tract neoplastic syndrome
194 8.9 Treatment of vaginal intraepithelial neoplasia
199 8.10 Further reading
204 9 Vulval Intraepithelial Neoplasia
205 9.1 Introduction
205 9.2 Epidemiology and pathogenesis
205 9.3 Natural history of vulval intraepithelial neoplasia: the rationale for treatment?
207 9.4 Pathology
209 9.5 The clinical examination in general
211 9.6 The clinical examination (specific)
215 9.7 Vulval intraepithelial neoplasia affecting the pilosebaceous unit
222 9.8 Superficially invasive carcinoma of the vulva
223 9.9 Lichen sclerosus
228 9.10 Paget's disease (non-squamous intraepithelial neoplasia)
230 9.11 Vulval lesions masquerading as cancer or precancer
231 9.12 Skin and accessory appendages that are important for the management of vulval intraepithelial neoplasia
237 9.13 Management of vulval intraepithelial neoplasia
239 9.14 Treatment of superficial invasive vulval carcinoma
254 9.15 Further reading
255 10 Perianal and Anal Intraepithelial Neoplasia
256 10.1 Epidemiology
256 10.2 Etiology
256 10.3 Association with other genital intraepithelial neoplastic diseases
257 10.4 Examination
257 10.5 Presentation
258 10.6 Lesions masquerading as intraepithelial neoplasia
260 10.7 Anal canal involvement
261 10.8 Management and treatment
262 10.9 Further reading
267 11 Genital Tract Adenosis
268 11.1 Introduction
268 11.2 Developmental anatomy
268 11.3 Developmental anomalies caused by diethylstilbestrol
269 11.4 Present situation
272 11.5 Further reading
272 12 Infective and Other Conditions Causing Confusion in Diagnosis of Lower Genital Tract Precancer
273 12.1 Introduction
273 12.2 Trichomonas vaginalis
273 12.3 Bacterial vaginosis
273 12.4 Candidiasis
274 12.5 Herpes genitalis infection
275 12.6 Human papillomavirus infection
279 12.7 Cervical deciduosis in pregnancy
280 12.8 Polypoid lesions of the cervix
282 12.9 Further reading
285 Index
287