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PAPILLARY IMMATURE METAPLASIA OF THE CERVIX - A DISTINCT SUBSET OF EXOPHYTIC CERVICAL CONDYLOMA ASSOCIATED WITH HPV-6/11 NUCLEIC-ACIDS
Faculty
Not Specified
Year:
1992
Type of Publication:
Article
Pages:
391-395
Authors:
CRUM, CP, SALEH, AM, WARD, BE, WILLIAMS, JV, ZITZ, JC
Journal:
MODERN PATHOLOGY WILLIAMS \& WILKINS
Volume:
5
Research Area:
Pathology
ISSN
ISI:A1992JD53400007
Keywords :
PAPILLOMA, CONDYLOMA, IMMATURE METAPLASIA, PAPILLOMAVIRUSES, CERVICAL INTRAEPITHELIAL NEOPLASIA
Abstract:
A subset of exophytic cervical precursor lesions are composed of immature metaplastic cells that differ from conventional condylomata by the virtual absence of koilocytotic atypia and the presence of slender filiform papillae. We evaluated a series of exophytic cervical lesions containing this morphology for HPV nucleic acids and compared the associated HPV types with conventional exophytic condylomata of the cervix. Six of six exophytic condylomata and five of six papillary immature metaplasias (PIM), respectively, contained HPV type 6/11 by in situ hybridization. Subtyping of three PIM by polymerase chain reaction combined with direct sequencing revealed nucleic acid sequences consistent with HPV 6/11. PIM were distinguished from high-grade squamous intraepithelial lesions by the rarity of mitoses and by the uniformity of nuclear size and staining intensity with multiple chromocenters. However, these lesions tended to involve the more cephalad region of the cervical transformation zone, and three cases extended deeply into the endocervix with two requiring conization for a definitive diagnosis. Although their bland morphology and association with HPV 6/11 nucleic acids suggest a benign process, their location within the endocervical canal implies that these variants of condyloma may differ biologically from conventional exophytic condylomas of the cervix. The differential diagnosis of PIM and potential explanations for their distinctive morphology, are discussed.
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