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The cells on the 'outside' of the cervix are typically squamous epithelial cells. Where the two cells meet is called the transformation zone, also known as the stratified squamous epithelium. Cervical ectropion can be grossly indistinguishable from early cervical cancer and must be evaluated by a physician to determine risks and prognosis.
Colposcope Transformation zone types: [11] Type 1: Completely ectocervical (common under hormonal influence). Type 2: Endocervical component but fully visible (common before puberty). Type 3: Endocervical component, not fully visible (common after menopause). During the initial evaluation, a medical history is obtained.
Cervical polyps, which are benign overgrowths of endocervical tissue, if present, may cause bleeding, or a benign overgrowth may be present in the cervical canal. [46] Cervical ectropion refers to the horizontal overgrowth of the endocervical columnar lining in a one-cell-thick layer over the ectocervix.
Transformation zone. The earliest microscopic change corresponding to CIN is epithelial dysplasia, or surface lining, of the cervix, which is essentially undetectable by the woman. The majority of these changes occur at the squamocolumnar junction, or transformation zone, an area of unstable cervical epithelium that is prone to abnormal changes ...
The cervical canal is generally lined by "endocervical mucosa" which consists of a single layer of mucinous columnar epithelium. However, after menopause, the functional squamocolumnar junction moves into the cervical canal, and hence the distal part of the cervical canal may be lined by stratified squamous epithelium (conforming to a "type 3 transformation zone").
A Pap smear is performed by opening the vagina with a speculum and collecting cells at the outer opening of the cervix at the transformation zone (where the outer squamous cervical cells meet the inner glandular endocervical cells), using an Ayre spatula or a cytobrush. The collected cells are examined under a microscope to look for abnormalities.
The cervical transformation zone and lesion are excised to an adequate depth, which in most cases is at least 8 mm, and extending 4 to 5 mm beyond the lesion. A second pass with a more narrow loop can also be done to obtain an endocervical specimen for further histologic evaluation. [8]
Diagram showing the transformation zone on the cervix. Date: 30 July 2014 (released by CRUK) Source: Original email from CRUK: Author: Cancer Research UK: Permission (Reusing this file) This image has been released as part of an open knowledge project by Cancer Research UK. If re-used, attribute to Cancer Research UK / Wikimedia Commons