Cervix
Premalignant / preinvasive lesions - H&E
Condyloma acuminatum
Author: Seema Khutti, M.D.
Topic Completed: 1 August 2013
Minor changes: 27 November 2020
Copyright: 2013-2021, PathologyOutlines.com, Inc.
PubMed search: Condyloma
See also: immature condyloma
Table of Contents
Definition / general | Terminology | Epidemiology | Sites | Etiology | Clinical features | Radiology description | Variants | Treatment | Clinical images | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Positive stains | Negative stains | Electron microscopy description | Molecular / cytogenetics description | Differential diagnosisCite this page: Khutti S. Condyloma acuminatum. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixcondyloma.html. Accessed January 24th, 2021.
Definition / general
- Cervical cancer precursor lesion (Int J Cancer 2006;119:888)
- Subcategory of LSIL
Terminology
- Also known as exophytic condyloma, mature exophytic LSIL
Epidemiology
- True prevalence unknown, up to 3.0% of Pap smears reported as SIL
- Incidence may decrease in younger women following HPV vaccine (Am J Public Health 2012;102:833)
Sites
- Transformation zone, exocervix
Etiology
- Strongly associated with HPV subtypes 6 and 11
Clinical features
- Commonly sexually transmitted, peaks second and third decade
- Tends to recur; enlarges during pregnancy; may regress without treatment
- May be diagnosed as ASC-US if all features are not present
Radiology description
- Raised polypoid or papillary lesion with prominent vasculature
Variants
- Giant Condyloma: uncommon but important variant, presents as large tumor of cervix and distal vagina, misdiagnosed as verrucous carcinoma (Am J Surg Pathol 2013;37:300)
- Immature condyloma / papillary immature metaplasia: metaplastic squamous cells with nuclear enlargement, occasional binucleation, uniform nuclear contours, minimal hyperchromasia (Diagn Cytopathol 1998;18:416)
Treatment
- Excisional biopsy, diathermy or laser vaporization
Clinical images
Contributed by Seema Khutti, M.D.
Colposcopy
Gross description
- Typically multifocal, white and exophytic; may be papillary
Microscopic (histologic) description
- Characterized by verruciform growth pattern with blunt shaped papillae acanthosis, atypical parakeratosis and hyperkeratosis, koilocytosis in middle and upper epithelium, minor atypia is common
Microscopic (histologic) images
AFIP images
Spiked excrescences
Cytology description
- See Cervix-Cytology
Positive stains
- KI67 stains basal to intermediate cells (Cancer 1991;68:1340)
Negative stains
- p16 usually weak or negative (Am J Surg Pathol 2001;25:884)
Electron microscopy description
- Viral particles contained in nuclei of superficial epithelial cells, most particles are single and either freely scattered throughout nucleoplasm or closely associated with chromatin clumps (J Clin Pathol 1981;34:532
Molecular / cytogenetics description
- PCR yields 100% detection rate of HPV 6 and HPV11 (Yi Chuan 2005;27:699)
Differential diagnosis
- Filiform mucosal excrescences of vagina: no prominent acanthosis, no nuclear atypia, no atypical parakeratosis
- Squamous papilloma: thick fibrovascular core, lacks hyperkeratosis and koilocytosis
