Related Experiment Videos
Postmenopausal squamous atypia: a spectrum including "pseudo-koilocytosis"
A S Jovanovic1, C M McLachlin, L Shen
1Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Summary
Postmenopausal squamous atypia (PSA) involves cervical cell changes that are not caused by human papillomavirus (HPV). These changes mimic low-grade lesions but are distinct from HPV-related conditions.
Area of Science:
- Gynecologic Pathology
- Cervical Cytology
- Viral Oncology
Background:
- Postmenopausal cervical biopsies can show atypia, including halos and nuclear changes.
- The origin of these changes (age-related vs. HPV-related) is unclear.
- Distinguishing these changes from low-grade squamous intraepithelial lesions (LSIL) is clinically important.
Purpose of the Study:
- To investigate the nature of postmenopausal squamous atypia (PSA).
- To determine if PSA represents age-related changes or HPV-related lesions.
- To identify features that differentiate PSA from HPV-associated condyloma.
Main Methods:
- Surveyed 30 cervical biopsies from postmenopausal women with characteristic atypia.
- Analyzed nuclear alterations, multinucleation, and perinuclear halos.
- Performed HPV Polymerase Chain Reaction (PCR) analysis on biopsies.
- Compared findings with a cohort of 141 LSIL and high-grade squamous intraepithelial lesions (HSIL).
Main Results:
- None of the 30 PSA biopsies were positive for HPV.
- This contrasts with a high HPV detection rate in LSIL/HSIL.
- PSA exhibited less nuclear size/staining variation and more uniform halos compared to HPV-related lesions.
- Specific features like finely distributed chromatin also distinguished PSA.
Conclusions:
- Postmenopausal squamous atypia (PSA) is not associated with HPV infection.
- PSA represents distinct age-related changes, not HPV-induced condyloma.
- PSA should be differentiated from LSIL in postmenopausal women, especially when koilocytotic atypia is the basis for diagnosis.