Investigation of choice for cervical neoplasm is: September 2011
Ans. C: Cone biopsy Pap smear (routine cytological screening) should be offered to all women over the age of 21 years who are sexually active for at least 3 years. In abnormal Pap tests, treat any accompanying inflammatory pathology and repeat the Pap test If it persists to be abnormal, consider colposcopic examination and selective biopsies Cone biopsy is both diagnostic and therapeutic MC (of Cervical Ca): Virus associated with squamous cell Ca: HPV 16 Virus associated with adeno Ca: HPV 18 Virus associated with verrucous Ca: HPV 6 Presenting feature: Bleeding per vaginum Site of tumour: Squamo-columnar junction (ectocervix) Agent: HPV 16 Group of lymph nodes affected: Obturator, hypogastric and external iliac Histological type: Squamous cell tumours Cause of death: Renal failure Remember: Earliest symptom of Ca cervix: Post coital bleeding Best method of screening for Ca cervix: Pap smear Best method of diagnosing Ca cervix: Cervical biopsy Ca in Situ may have 100% cure rate Treatment of : - Stage II: Extended hysterectomy, chemotherapy and intracavitary brachytherapy - Stage III: Radiotherapy and chemotherapy Cone biopsy is therapeutic in: CIN III
Speculoscopy
Pap smear
Cone biopsy
Cervicography