Human papillomavirus infection in atrophic smears. A case report.
BACKGROUND
Human papillomavirus (HPV) infection in atrophic smears can be misleading and may produce the diagnosis of cervical intraepithelial neoplasia.


METHODS
A routine cervical smear in a 62-year-old female revealed an atrophic smear with nuclear changes suggestive of a high grade squamous intraepithelial lesion (HSIL). An estrogen cream for topical vaginal use was prescribed. A new smear was collected seven days later and revealed koilocytosis but no evidence of HSIL.


CONCLUSIONS
Koilocytosis is a cellular finding of mature epithelial cells. The use of estrogen produces maturation of HPV-infected basal cells, allowing a correct diagnosis of this disease in patients with atrophic smears.
Luzzatto
R
R
Institute of Pathology, Porto Alegre, Rio Grande do Sul, Brazil.
Poli
M
M
Recktenvald
M
M
Luzzatto
L
L
D001284:Atrophy; D003937:Diagnosis, Differential; D004967:Estrogens / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008875:Middle Aged; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D014412:Tumor Virus Infections / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000473:pathology
D004967:Estrogens