Flat Condyloma Research Articles

Presence of human papillomavirus in genital tumors.

Human papillomavirus (HPV) types 16 and 18 have been identified in two different human cervical carcinomas. The viral DNAs were molecularly cloned and used as probes to screen a large number of genital tumors by Southern blot analysis. HPV-16 or HPV-18 sequences, respectively, were found in a high percentage of cervical carcinomas, but only in a small number of condylomata acuminata or flat condylomas. The majority of the latter lesions, however, contained HPV-6 or HPV-11 sequences, respectively, which in contrast were detected only rarely in carcinomas in situ or invasively growing carcinomas. A similar distribution of the different papillomaviruses was observed when cell swabs taken from the cervix were tested by in situ hybridization.

Presence of Human Papillomavirus in Genital Tumors

Human papillomavirus (HPV) types 16 and 18 have been identified in two different human cervical carcinomas. The viral DNAs were molecularly cloned and used as probes to screen a large number of genital tumors by Southern blot analysis. HPV-16 or HPV-18 sequences, respectively, were found in a high percentage of cervical carcinomas, but only in a small number of condylomata acuminata or flat condylomas. The majority of the latter lesions, however, contained HPV-6 or HPV-11 sequences, respectively, which in contrast were detected only rarely in carcinomas in situ or invasively growing carcinomas. A similar distribution of the different papillomaviruses was observed when cell swabs taken from the cervix were tested by in situ hybridization.

Koilocytotic lesions of the cervix. The relationship of mitotic abnormalities to the presence of papillomavirus antigens and nuclear DNA content.

It has been reported that abnormal mitotic figures (AMFs) occur principally in aneuploid lesions and that aneuploidy is a diagnostic feature of non-endocrine-dependent epithelial cancer precursors and cancers. Recently, AMFs have been reported in cervical lesions interpreted as flat condylomata, and it has been suggested by several authors that AMFs may not be diagnostic or aneuploidy or neoplasia, particularly in human papillomavirus-(HPV)-induced lesions. Although it is conceivable that AMFs may be a regular feature of HPV infection, their association with cytologic atypia and their presence in higher grades of cervical intraepithelial neoplasia (CIN) suggests that AMFs may herald the presence of a different lesion than the pure flat condyloma. In the current study, koilocytotic cervical lesions thought to be HPV-induced were examined microscopically for the presence of AMFs, and the findings were correlated with the presence of HPV as determined by immunoperoxidase and nuclear DNA distribution patterns as measured by Feulgen microspectrophotometry. In unselected lesions originally diagnosed as flat cervical condylomata, AMFs were surprisingly common (22.6%), and did not correlate with the extent of koilocytosis. Immunoperoxidase (IMPO) stains were performed in 35 cases with AMFs, and were negative for HPV in 74.3% and positive in 22.8%. However, among the cases evaluated by IMPO, there was an inverse relationship between the presence of mitotic abnormalities and the expression of HPV antigen. Nine of 11 (81.8%) lesions containing AMFs were aneuploid, and 2 of 11 (18.2%) were polyploid. Abnormal mitotic figures have a range of morphology and frequency in koilocytotic cervical lesions. Although the biology of these lesions is not well-defined, the presence of AMFs may identify a subgroup of HPV-induced cervical atypias which represent a transition between flat cervical conylomata and CIN.

Diagnosis and Epidemiology of Condyloma Acuminatum-Reply

In Reply.— We thank Drs Katz and Weiss for elaborating on the epidemiology and diagnosis of condyloma and their relationship to HPV. We agree entirely that the NDTI data on the incidence of condyloma acuminatum areminimumestimates of sexually transmitted HPV infections. If we were to add the diagnoses of flat condyloma, cervical intraepithelial neoplasia (CIN), and other genital neoplasms to the spectrum of HPV lesions, the incidence would be much greater. Thus, we concur that HPV is a very common—and probably the most neglected—sexually transmitted infection. Even though the NDTI data minimized both the spectrum and the magnitude of HPV infections, we believe that they accurately reflecttrendsof condyloma acuminatum during the past 15 years. They demonstrate that the incidence of HPV lesions has dramatically increased. This rise is consistent with trends in other STDs, such as genital herpes andChlamydia trachomatis, for which we have inadequate

The relation between the type of immunoreactive cells found in human papillomavirus (HPV) lesions of the uterine cervix and the subsequent behaviour of these lesions.

Human papillomavirus (HPV) lesions in the skin are rejected by immunological mechanisms, but very little is known about such mechanisms in HPV lesions of the uterine cervix. We studied the mononuclear cell infiltrates in cervical biopsies from 65 women with an HPV lesion (flat, inverted or papillomatous condyloma) who were followed for at least twelve months. We examined cryostat sections using the ANAE (acid alpha-naphthylacetate esterase) technique to demonstrate B cell, T cells, and mononuclear phagocytes (MPs), and monoclonal antibodies (OKT3, OKT4, OKT6, and OKT8) for the T cell subsets. The percentages of B-, T-, and MPs in HPV lesions with concomitant cervical intraepithelial neoplasia (CIN) were similar to those lesions without CIN. Similarly, no significant differences in cell type percentages were found in HPV lesions which regressed (n = 24), remained stationary (n = 24) or progressed (n = 3) during the follow-up period. The ratio OKT4+/OKT8+ (T helper/T suppressor, cytotoxic) cells was 1.44 and 0.81 in HPV lesions with CIN and those without CIN respectively (p less than 0.025). No statistically significant differences in that ratio were found between the lesions which remained stationary, regressed or progressed. The tendency to progress was directly related to the degree of CIN associated with HPV.

Morphological and immunohistochemical evidence suggesting human papillomavirus (HPV) involvement in oral squamous cell carcinogenesis

Human papillomavirus (HPV) is an agent responsible for squamous cell tumors (Verrucae, condylomata and papillomas) at various sites of the body, the oral cavity included. Due to the recently pointed-out association between these HPV lesions and the squamous cell dysplasias and malignancies in the uterine cervix, in the bronchus and in the larynx, the present work was carried out to assess, whether morphological signs (cytopathic effects of HPV) or HPV antigens could be found in lesions of oral squamous cell carcinomas. Biopsies from 40 cases of oral squamous cell carcinomas were surveyed by light microscopy with special emphasis on the presence of the histopathological features suggesting an HPV lesion, i.e. whether flat, inverted or papillomatous condylomas are present concomitantly with the malignancy. All specimens were also subjected to immunoperoxidase staining with anti-HPV serum to disclose the possible HPV antigens in the lesions. Morphological signs of the flat-type HPV lesion were found in 4 cases (10%), those of an inverted type in 3 cases (7.5%), and those of a papillomatous type in 9 cases (22.5%). Epithelial cells (mostly koilocytes) showing HPV-positive nuclei were disclosed in 5 papillomatous lesions, in 2 inverted lesions and in 1 flat lesion. The results suggest that HPV might be the agent involved in the development of at least certain special types of oral squamous cell carcinomas; albeit further confirmatory evidence with other techniques (DNA hybridization) is still needed.

Condyloma and cervical epithelial atypias in young women

One hundred and three adolescent women with cervical cytology suggestive of mild to moderate dysplasia were studied for the presence of condylomatous lesion. The analysis of smears revealed cells suggestive of condyloma in 81% of the cases. In histopathologic studies cervical lesions typical of condyloma were observed in 59 preparations. Of these 16 were papillary and 35 were flat condylomas, and in 8 cervices both papillary and flat condylomatous lesions were present. Colposcopic examination showed an atypical transformation zone in 57 cases. Papillary condylomas were present in 24 cervices in 7 cases combined with an atypical transformation zone. In addition to the cervical epithelial atypias there were 18 cases in which colposcopic and histologic examination of vagina revealed papillary warts, 13 of them combined with cervical condylomas. In four patients vaginal leucoplakia was seen and all were histologically flat condylomas. Thus, in 68 cases or in 66% of adolescent women having abnormal cervical cytology, histological investigation revealed condylomatous changes.

Histopathology of papilloma virus infection of the cervix uteri: the history, taxonomy, nomenclature and reporting of koilocytic dysplasias.

Papilloma virus infections of the squamous cervix are common and determine the incidence of koilocytes in cervical smears and biopsies. Typical exophytic condyloma acuminatum accounts for few of the infections. Most are "flat condylomata" (flat koilocytosis)--slightly raised plaques of flat profile. Superficial koilocytosis, dyskeratosis and often disturbed deep cells are their main histological features. The association between koilocytosis and dysplasia is considered and the different taxonomic approaches to the koilodysplastic states are compared. Equivalence is established between different nomenclatures by reference to the familiar dysplastic grades. Methods of reporting koilodysplasias are given and a prognostically difficult state of "full thickness" or "plenary" koilocytosis is described. In applying the "high technology" of nucleic acid hybridisation to confirm the lesion specificity of papilloma virus strains the lesions must be well defined and clearly identified by precise nomenclature: the nature and nomenclature of the lesions is critically discussed.

Immunoperoxidase staining for involucrin: A potential diagnostic aid in cervicovaginal pathology

Involucrin, a protein subunit of keratinocyte cross-linked envelopes, is a distinctive marker for suprabasal differentiation in stratified squamous epithelium. Immunoperoxidase staining for involucrin was used to evaluate paraffin sections of tissue obtained by colposcopically directed biopsies of infectious, metaplastic, and dysplastic lesions of the cervix and vagina. Areas of normal squamous epithelium, papillary and flat condyloma acuminatum, and mature and immature squamous metaplasia showed positive staining in 99 per cent of samples lacking significant inflammation and in 60 per cent of those with moderate or severe inflammation. In contrast, only 19 per cent of the squamous cell dysplasias, even those without much inflammation, showed positive staining, and no area with moderate or severe inflammation showed positive staining. These findings indicate that expression of involucrin is modulated by cellular pathologic features and microenvironment. We suggest that immunoperoxidase staining for involucrin may be useful in distinguishing mild dysplasia from immature metaplasia and flat condyloma in some biopsy specimens in which routine histologic examination yields an indeterminate diagnosis.

Immunoperoxidase demonstration of human papilloma virus (HPV) in dysplastic lesions of the uterine cervix.

Routinely processed sections of 47 unselected cervical dysplasias and in situ carcinomas (both condylomatous, CO, and noncondylomatous, NCO) were subjected to staining with indirect immunoperoxidase-PAP technique using anti-human papilloma virus (anti-HPV) immune serum to demonstrate HPV antigens in these lesions. Anti-HPV was raised in guinea pigs immunized with highly purified virions from a pool of human skin wart tissues. Positive reactivity for HPV (brown intranuclear precipitates) was disclosed in 72% of the CO dysplasias and in only one case (5.6%) of the NCO group. The frequency of HPV-positive lesions was inversely related to the degree of epithelial dysplasia, being consistent with the disappearance of ultrastructurally detectable virus particles in lesions turned malignant. HPV-containing cells were characteristic koilocytes or dyskeratotic superficial cells. The present technique provides definite evidence for the HPV etiology of the flat, inverted, and papillomatous condylomas, and seems to offer an advantage as a diagnostic tool of these lesions. When applied to malignant tumors in the near future, the method will undoubtedly bring more light on the suggested role of HPV in the etiology of human squamous cell carcinomas of the uterine cervix and other sites as well.

Association of human papillomavirus with neoplastic processes in the genital tract of four women with impaired immunity

The presence of papillomavirus particles was documentd by electron microscopy in atypical squamous epithelium of the cervix, vagina, and vulva, and in cells derived therefrom in four women with compromised immune status who were being followed in our clinics. Three of the patients had treated Hodgkin's disease, and one a dermatologic disorder, perhaps akin to epidermodysplasia verruciformis. Initially, all four patients developed treatment-resistant condylomata acuminata of the vulva and adjacent areas. Subsequently, one of the patients was shown to harbor in the vagina a focus of markedly atypical epithelium, perhaps a flat condyloma. Two other patients, followed for several years, developed multiple epidermoid carcinomas in situ affecting the cervix, vagina, and vulva. In one of these two latter patients the disease progressed to multiple foci of superficially invasive carcinoma. The possible role of the human papillomavirus in the genesis of these lesions is discussed.

Histological evidence for the presence of condylomatous epithelial lesions in association with laryngeal squamous cell carcinoma.

The laryngeal specimens obtained from 116 patients with established invasive squamous cell carcinoma of the larynx were histologically assessed with special reference to the detection of morphological manifestations of human papilloma virus (HPV), as newly described in the uterine cervix, i.e. the three different types of condylomas (the papillomatous, the flat and the inverted ones). Epithelial changes fulfilling the criteria of the papillomatous condyloma were found in 15 cases, those of the inverted condyloma in 9 cases, and lesions identical to the flat type condyloma were present in 25 specimens. The role of HPV in the development of these lesions is discussed, and the possibility is raised that HPV might be the agent responsible for or contributing to the development of squamous cell carcinoma of the larynx in man.

Bronchial squamous cell carcinomas associated with epithelial changes identical to condylomatous lesions of the uterine cervix.

Specimens from 220 patients with an invasive squamous cell carcinoma of the bronchus were histologically assessed for morphological criteria associated with human papilloma virus (HPV) in uterine cervix, i.e. the three different types of condylomatous lesions (papillomatous, flat and inverted). Histological lesions fulfilling the criteria of the papillomatous condyloma were found in ten cases, those of the inverted condyloma in six cases, and lesions identical to the flat type condyloma were present in 51 specimens. The role of HPV in the development of these lesions is discussed and the possibility raised that HPV might be involved in squamous cell carcinogenesis of the bronchus in man, although further confirmatory evidence by other methods is needed.

Condylomatous epithelial changes in the uterine cervix and their relationship to cervical carcinogenesis.

Two hundred twenty-six (226) women with histologically verified dysplastic or neoplastic epithelial lesions in the uterine cervix were assessed for the presence (CO-series) or absence (N-CO-series) of the three newly established types of condylomatous lesions. Both the CO-series and the N-CO-series comprised 113 patients. Histologic changes fulfilling the previously outlined criteria of the (a) flat, (b) inverted and (c) papillomatous condylomas were found in association with all degrees of epithelial atypia, from mild dysplasia to frankly invasive carcinoma. The flat type was most common, comprising 69% of all condylomas. The inverted and papillomatous types were relatively rare, with frequencies of 18.6% and 12.4%, respectively. The mean age of the patients in the CO-series was 30.9 years, that of the N-CO-series patients was 39.3 years (p less than 0.0001). The causal relationship between the cervical condylomas and cervical carcinoma is discussed. The conclusion is drawn that this possibility needs to be seriously considered when searching for a venereally transmitted agent as an etiologic factor of cervical carcinoma.

Condylomatous Epithelial Changes in the Uterine Cervix and Their Relationship to Cervical Carcinogenesis

Two hundred twenty-six (226) women with histologically verified dysplastic or neoplastic epithelial lesions in the uterine cervix were assessed for the presence (CO-series) or absence (N-CO-series) of the three newly established types of condylomatous lesions. Both the CO-series and the N-CO-series comprised 113 patients. Histologic changes fulfilling the previously outlined criteria of the (a) flat, (b) inverted and (c) papillomatous condylomas were found in association with all degrees of epithelial atypia, from mild dysplasia to frankly invasive carcinoma. The flat type was most common, comprising 69% of all condylomas. The inverted and papillomatous types were relatively rare, with frequencies of 18.6% and 12.4%, respectively. The mean age of the patients in the CO-series was 30.9 years, that of the N-CO-series patients was 39.3 years (p less than 0.0001). The causal relationship between the cervical condylomas and cervical carcinoma is discussed. The conclusion is drawn that this possibility needs to be seriously considered when searching for a venereally transmitted agent as an etiologic factor of cervical carcinoma.

Epithelial lesions suggestive of a condylomatous origin found closely associated with invasive bronchial squamous cell carcinomas.

The histology of the bronchial specimens derived from 104 patients with an established invasive bronchial squamous cell carcinoma was assessed with special reference to the detection of the morphological manifestations of human papilloma virus (HPV) recently described in the uterine cervix, i.e., three different types of condylomatous lesions (papillomatous, flat and endophytic). Histological lesions fulfilling the criteria of papillomatous condyloma were found in 6 cases, those of endophytic condyloma in 4 cases, and lesions identical to flat type condyloma of the uterine cervix were encountered in 26 cases (25%). The role of HPV in the development of these lesions and their relationship to squamous cell carcinogenesis was discussed, and a concept hypothesizing the development of bronchial squamous cell carcinoma is outlined.

Morphologic survey of the condylomatous lesions in dysplastic and neoplastic epithelium of the uterine cervix.

One hundred eighty-four women with a histologically verified dysplastic or neoplastic lesion in the uterine cervical epithelium were histologically assessed with special reference to the presence of the various histological types of condyloma in these epithelial specimens. Histological changes fulfilling the previously outlined criteria of the flat, inverted, and papillomatous condylomas were encountered in 91 (49.4%) women. Condylomatous lesions were seen in association with all degrees of epithelial atypia from mild dysplasia to frankly invasive cervical carcinoma, which seemed to develop at significantly earlier age when concomitant condylomatous lesion was present than with its absence (p less than 0.001). The serious consideration of the relationship between the condylomatous lesions and the uterine cervical was emphasized.

Case of flat condylomata of the vocal cords

The LaryngoscopeVolume 10, Issue 2 p. 148-148 Selected AbstractFree Access Case of flat condylomata of the vocal cords Tanturri, TanturriSearch for more papers by this author Tanturri, TanturriSearch for more papers by this author First published: February 1901 https://doi.org/10.1288/00005537-190102000-00024AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume10, Issue2February 1901Pages 148-148 RelatedInformation