On colposcopy, aceto-white epithelium with a coarse mosaic pattern and an atypical transformation zone type 3 is identified. Which feature specifically predicts the highest risk of high-grade cervical intraepithelial neoplasia (CIN 3)?
- A Fine punctation pattern
- B Dense acetowhitening with coarse mosaic ✓
- C Iodine-positive staining
- D Metaplastic squamous epithelium at transformation zone
Correct answer: B. Dense acetowhitening with coarse mosaic
Explanation
Dense acetowhitening (thick, oyster-white) combined with coarse mosaic or coarse punctation on colposcopy are high-grade colposcopic features correlating with CIN 2–3 or invasion. Fine patterns and faint acetowhitening suggest low-grade changes. Iodine positivity (Schiller-negative result = iodine uptake = glycogen-containing normal or metaplastic epithelium) actually indicates a benign or low-risk area. Metaplastic epithelium is physiological.
Reference: Shaw's Textbook of Gynaecology, 17th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.