Cervical condylomatous atypia and its relationship to cervical neoplasia

Seven hundred fifty-six consecutive cervical biopsy specimens were obtained for abnormal Pap smear results or abnormality on physical examination to determine the incidence of condylomatous atypia (CLA) and its association with true dysplasia (cervical intraepithelial neoplasia; CIN). Histopathologic criteria for the diagnosis of CLA and its distinction from CIN were developed and are defined and illustrated. Clinicopathologic evaluation disclosed (1) CLA is often overdiagnosed as dysplasia; (2) cervical CLA is often associated with CLN in the same patient and may represent a potential precursor lesion; (3) CLA occurs more frequently than CIN in younger patients; and (4) the mean age of patients with pure CLA is younger than combined CLA-CIN, which is in turn younger than individuals with pure CIN. The results of this study are evaluated in light of induced squamous carcinoma and in view of the known associated of condylomata and cancer of the external genitalia in humans. The results strongly indicate a need to examine the cervical CLA-CIN association with careful epidemiopathologic studies.