Biopsy of the Cervix

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Biopsy of the Cervix

Randomized biopsy of the cervix is indicated whenever a gross lesion of the cervix is seen. All too often, gross lesions are diagnosed on sight as cervical "erosions or eversions" without histologic confirmation. The Papanicolaou smear alone is not sufficient for diagnosing gross lesions of the cervix.

The purpose of the operation is to obtain a histologic specimen of the squamocolumnar junction of the cervix.

Physiologic Changes. None.

Points of Caution. Cervical carcinoma begins at the squamocolumnar junction. Therefore, it is essential that this junction to be taken in any biopsy of the cervix.

This operation has been illustrated in conjunction with Dilatation and Curettage.

Technique

The cervix is exposed and immersed in Schiller's iodine solution. The iodine solution will rapidly stain cells storing glycogen. Those cells with rapid nuclei division are generally glycogen depleted and therefore will not stain with the iodine solution. These areas are known as "Schiller white areas."

A sharp alligator-mouth biopsy forceps is placed at the junction of the Schiller dark and Schiller white areas; a liberal biopsy is obtained. This process is repeated in at least four other quadrants. Rarely is cauterization or suture of the biopsy site needed. A vaginal tampon is applied to the cervix to absorb the cervical bleeding. If hemostasis is required, a 4-0 synthetic absorbable suture or Avitene collagen hemostat can be applied to the cervix.