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

Abstract

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.