A 31-year-old woman complains of increased vaginal discharge of 3 months in duration. A cervical Pap smear is obtained. Two superficial squamous cells as shown in the image) display enlarged nuclei and perinuclear vacuoles koilocytotic atypia. What is the appropriate diagnosis?
Herpes simplex virus infection
Human papillomavirus (HPV) infection
Answer 😀 Human papillomavirus (HPV) infection
HPV is a DNA virus that infects a variety of skin and mucosal surfaces to produce wart-like lesions (verrucae and condylomata).
In the female reproductive tract, HPV infections are linked to the pathogenesis of cervical cancer.
The morphologic hallmark of HPV infection is koilocytotic atypia, a term that denotes the presence of sharply demarcated, large perinuclear vacuoles, combined with alterations in the chromatin pattern of squamous epithelial cells.
These perinuclear vacuoles are filled with replicating virus particles. Endometrial adenocarcinoma demonstrates eccentric nuclei with irregular nuclear membranes and abnormally distributed chromatin. Herpes simplex virus infection demonstrates multinucleation and “ground glass” nuclei.