This abnormal expansion of cells occurs with foci or layers of ballooning "koilocyte
More importantly, histological examination revealed no koilocyte
or evidence of cellular dysplasia, thereby excluding viral wart or any premalignant condition.
The nucleus of the koilocyte
is usually enlarged, hyperchromatic and irregular in outline.
containing enlarged and irregular nuclei, perinuclear halos, and coarse keratohyalin granules may be found in the granular and upper spinous layers.
Evidence of HPV infection was defined as the presence of koilocytes
and/or histological features of condylomata acuminata in the histopathology specimen (Figure 1).
Histopathological examination revealed pronounced acanthosis, vacuolated cells in stratum malpighii which appear to have round, hyperchromatic nuclei (koilocytes
), (Figure 5).
Additionally, physicians assess the grade of CIN lesions by observing on histology the biopsy material nuclear parameters such as size, shape, staining, pleomorphism (variations in size, shape, and staining of nuclei), chromatin patterns, mitotic activity and mitotic figures, and presence of koilocytes
and nucleoli [4, 5].
Biopsy showed fragments of squamous epithelium with koilocytes
and positive P16 staining by histochemistry consistent with HPV infection.
The squamous layer showed clear epithelial cells with a vacuolized nuclei, and some cells similar to koilocytes
were present in the upper layers of the epithelium.
Histopathological examination of the lesion revealed papillary structures presenting with hyperkeratosis, hypergranulosis, elongated retes showing a tendency to converge towards the center on a large and flat ground, and koilocytes
in the spinous layer and the lesion was determined to be consistent with verruca vulgaris (Figure 2).
43 nonneoplastic lesions include chronic polypoid endocervicitis (CPEC- 10 cases), Koilocytes
(3 cases), chronic cervicitis (12 cases), normal study (10 cases), acute-on-chronic cervicitis (7 cases), only haemorrhage (1 case).
As HPV testing was not available at our institution, histological results of vulvar biopsies and resected specimens were checked for cellular HPV changes, koilocytes
and usual-type vulvar intraepithelial neoplasia (uVIN) as well as lichen sclerosus.