Condylomatous lesions of the cervix and vagina. I. Cytologic patterns.

TLDR

Condylomatous lesions of the cervix and vagina are frequently missed by clinical examination and can be mistaken for mild dysplasia on cytology, colposcopy, or histology. In our screening program, 2 % of asymptomatic patients had cytologic evidence of condyloma, characterized by enlarged, multinucleated squamous cells with hyperchromasia, perinuclear clearing, amphophilia, and dyskeratosis, and many lesions previously classified as mild dysplasia were re‑identified as condylomatous, underscoring their role as early precursors of cervical carcinoma.

Abstract

Condylomatous lesions, although readily diagnosed on the vulva, are often missed in the vagina and on the cervix by clinical examination alone. The lesions are, however, quite common and may be misdiagnosed as mild dysplasia by cytology, colposcopy and even tissue examination. Condylomatous lesions are presently diagnosed on cytologic evidence in nearly two per cent of asymptomatic patients screened in our program and followed-up by colposcopy and tissue examination, when indicated. The cytologic presentation of these lesions is quite characteristic. The main features are seen in squamous cells: enlargement, bi- or multinucleation, hyperchromasia, peri-nuclear clearing, amphophilia and dyskeratotic changes. Our present experience indicates that a large number of lesions previously classed as mild dysplasias actually represent various stages of condylomatous lesions. When these stages of viral changes are removed from the group of dysplasias, the remaining cases become of much greater significance as the early stages of evolution of carcinomata of the cervix.