Which diagnostic procedure is most appropriate for a follow-up of cervical dysplasia?

The most appropriate follow-up diagnostic procedure for cervical dysplasia is a colposcopy-directed biopsy. This method allows for a detailed examination of the cervix using a colposcope, which provides magnification and illumination of the cervical tissue. If abnormal areas are detected during colposcopy, a biopsy can be taken directly from those areas. This targeted approach helps ensure that any potential dysplastic areas are accurately sampled for histological examination.

In contrast, a cone biopsy is typically reserved for cases where there is a significant level of dysplasia or when the results of a biopsy indicate invasive disease. It involves removing a larger, cone-shaped piece of cervical tissue and is more invasive than a simple biopsy. Aspiration needle biopsy is not commonly used for cervical pathology as it is more suited for sampling tissue from masses or cysts in other areas. Dilation and curettage, primarily used for intrauterine conditions such as abnormal uterine bleeding, is not indicated for cervical dysplasia.

Thus, colposcopy-directed biopsy is the most appropriate choice, as it is specifically designed for follow-up and assessment of cervical dysplasia.