Differentials
Human papillomavirus (HPV) infection
SIGNS / SYMPTOMS
No mass; no abnormal bleeding; usually no symptoms.
INVESTIGATIONS
HPV testing is indicated with an abnormal cervical cytology test (atypical squamous cells of undetermined significance).
The term koilocyte refers to the characteristic appearance of HPV-infected cells and is pathognomonic for the presence of HPV. Koilocytosis often remits, but true dysplasia needs further investigation and follow-up.
Pelvic infection
SIGNS / SYMPTOMS
Chlamydia and gonorrhoea are associated with fever, pain, and vaginal discharge, but may be asymptomatic.
INVESTIGATIONS
Cytology may be indeterminate due to inflammatory changes. Chlamydia and gonorrhoea nucleic acid amplification testing, wet prep, culture, potassium hydroxide (KOH) testing can identify infection.
Nabothian cyst
SIGNS / SYMPTOMS
No specific differential signs or symptoms.
INVESTIGATIONS
Distinguished on clinical examination.
Glandular hyperplasia
SIGNS / SYMPTOMS
May be a cytology finding in an asymptomatic patient.
Some patients may have symptoms of heavy, prolonged, frequent, and short or irregular uterine bleeding.
INVESTIGATIONS
Atypical glandular cells on cytology; diagnostic biopsy will distinguish this from cervical cancer.
Mesonephric remnants
SIGNS / SYMPTOMS
No specific differential signs or symptoms.
INVESTIGATIONS
Diagnostic biopsy will distinguish this from cervical cancer.
Endometriosis
SIGNS / SYMPTOMS
Dysmenorrhoea, infertility, fatigue.
INVESTIGATIONS
Diagnostic biopsy will distinguish this from cervical cancer.
Cervical polyp
SIGNS / SYMPTOMS
No specific differential signs or symptoms.
INVESTIGATIONS
Diagnostic biopsy will distinguish this from cervical cancer.
Cervical fibroid
SIGNS / SYMPTOMS
Menorrhagia, painful mass, prolapse of the fibroid.
INVESTIGATIONS
Diagnostic biopsy will distinguish this from cervical cancer.
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