Cervix
Premalignant / preinvasive lesions - H&E
Condyloma acuminatum


Topic Completed: 1 August 2013

Minor changes: 27 November 2020

Copyright: 2013-2021, PathologyOutlines.com, Inc.

PubMed search: Condyloma

See also: immature condyloma


Seema Khutti, M.D.
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Cite this page: Khutti S. Condyloma acuminatum. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cervixcondyloma.html. Accessed January 24th, 2021.
Definition / general
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
Positive stains
Negative stains
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
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
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