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Human papillomavirus-related cervical lesions in adolescents: a histologic and morphometric study
Liane Deligdisch1, Carlos Roberto de Resende Miranda, Hai Shan Wu
1Department of Pathology, Mount Sinai Medical Center, New York, NY 10029, USA. liane_deligdisch@mssm.edu
Objective:
To evaluate the cytopathic effect of human papillomavirus (HPV) infection in adolescents.
Methods:
Cervical biopsies from 100 patients, 50 from adolescents age 14 to 20 and 50 from mature women age 35 to 64, all diagnosed with HPV-related lesions (condylomas), were studied histologically and morphometrically. Fifty were associated with low-grade squamous intraepithelial lesions and 50 with high-grade squamous intraepithelial lesions.
Results:
Epithelial cells with large hyperchromatic, often bizarre-shaped, nuclei, staining positive for HPV-16, were identified in most samples from adolescents. These nuclei were, on average, almost twice as large as those seen in biopsies from older women (P = 0.003), and they mostly occupied the lower half of the epithelium (P = 0.0008). These large cells were further analyzed for texture by a novel image-analysis approach, the autocorrelation factor beta, that revealed a markedly different, smoother nuclear structure, suggestive of a large viral load, different from the irregular chromatin pattern seen in dysplastic nuclei.
Conclusions:
These peculiar nuclei were ubiquitous in the adolescent cervical biopsies and probably represent a primary abundant productive viral infection. They should not necessarily be interpreted as dysplastic.