[A scanning electron microscope study of the fine angioarchitecture of "punctation" and "atypical vessels" (author's transl)].

The present study was aimed to evaluate the correlation of histologic findings with colposcopic findings of "punctation" and "atypical vessels". The stereoscopic angioarchitectures of "punctation" and "atypical vessels" were observed clearly by scanning electron microscope, utilizing cast formation technique of blood vessels on hysterectomy specimens. Scanning electron microscopy revealed following characteristic findings. 1) The angioarchitecture of "punctation" is composed of three strata. (a) subepithelial capillary network, (b) capillaries rise into the stromal papillae from subepithelial capillary network. (c) stromal vessels ending in subepithelial capillary network. 2) Stratum (b) is observed as "punctation" on colposcopy. 3) Stratum (b) alterate morphologically as follows; hairpin-like capillaries correspond to "punctation" in inflammation, gathered & twisted hairpin-like capillaries in dysplasia, asparagus-like vessels in C.I.S., cauliflower-like vessels in early invasive cancer, respectively. 4) The mesh of stratum (a) become denser as the lesions advance, and in early invasive cancer, the destruction of stratum (a) begin to appear. 5) The branchings of stratum (c) increase as the lesions advance. 6) Chaotic angioarchitecture is observed in invasive cancer, with complete destruction of stratum (a). 7) The morphologic alteration of stratum (b) is the most remarkable in three strata. Colposcopically, these alterations of angioarchitecture are observed as follows; in "punctation", "red spot" become larger and irregularity increase both in size, shape and arrangement, as the lesions advance, in "atypical vessels", "vascular pattern" increase irregularity both in shape, caliber, continuation and arrangement. As a result, by analysing these scanning electron microscopic pictures and comparing them with their colpophotographs and histologic findings, it can be emphasized that, it might be possible to make histologic diagnosis merely by colposcopy.