Relationship between cervical condylomata, pregnancy and subclinical papillomavirus infection.
From a retrospective study of 415 sets of colpophotographs, 25 clinically obvious condylomata of the cervix were identified. Two morphologically distinct forms were found and termed erythrocondylomata and leukocondylomata on the basis of their colposcopic appearance. Erythrocondylomata are red, raised lesions with diagnostic large capillary loops. Those lesions were found in young women (mean age, 22 years) and associated with pregnancy in 72% of cases. They were observed to involute and disappear to the naked eye within a few months of the diagnosis. Colposcopic and histologic studies, however, indicated that the lesions could persist in subclinical form. Of eight such lesions studied, five showed histologic and colposcopic features of subclinical papillomavirus infection, and two showed histologic features compatible with cervical intraepithelial neoplasia (CIN). Leukocondylomata are brilliant white lesions associated histologically with a thick layer of keratin over a typical condylomatous base. Those lesions occurred at a later age (mean, 32 years), were not associated with pregnancy and tended to increase rather than involute with time. Epidemiologic studies have indicated that it is the young and sexually active who are at most risk of developing cervical cancer. This study indicated that it is this same group that is also at highest risk of developing erythrocondylomata of the cervix. Such lesions have been shown to involve the squamocolumnar junction and transformation zone when that area is most active and vulnerable. The progression of such lesions to subclinical papillomavirus infection and CIN suggests that they may be involved in the initiation of the cervical neoplastic process.(ABSTRACT TRUNCATED AT 250 WORDS)
Garry
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Jones
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D000328:Adult; D000367:Age Factors; D000818:Animals; D001706:Biopsy; D002584:Cervix Uteri / Q000473:pathology*; D003127:Colposcopy; D003218:Condylomata Acuminata / Q000209:etiology / Q000473:pathology*; D005260:Female; D006801:Humans; D027383:Papillomaviridae; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000209:etiology / Q000473:pathology*; D012189:Retrospective Studies; D012306:Risk; D012725:Sexual Behavior; D014412:Tumor Virus Infections / Q000209:etiology / Q000473:pathology*; D002583:Uterine Cervical Neoplasms / Q000209:etiology / Q000473:pathology*