The new colposcopic terminology.

A generally acceptable scheme for the classification of colposcopic findings is critical for the more widespread acceptance of this valuable diagnostic tool. Older schemes have tended to confuse students. The scheme described in this article sets appearances against an order of events in time and place based on the biological life history of the organ. This amounts to the history of exposed columnar epithelium as it changes, by a typical or atypical process, into squamous epithelium to produce, respectively, a typical or atypical transformation zone. The former produces a homogeneous appearance, the latter a heterogeneous appearance requiring further subdivision by the use of the categories of white epithelium, blood vessel abnormalities such as punctation and mosaic and other atypical patterns, and leukoplakia. Not all of these abnormal appearances are associated with greatly altered histological appearances and, therefore, a further system of their grading is introduced. Other categories include appearances associated with overt cancer, with miscellaneous noncancerous conditions and with states in which the complete transformation zone is not viewed and, therefore, the colposcopic findings are not satisfactory. Finally, the present scheme is integrated as far as possible with older schemes.