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A case of peritoneal melanosis secondary to a ruptured benign cystic teratoma in a 28-year-old woman is reported. The patient had no history of cutaneous or ocular malignant melanotic lesions. The section of the left ovary contained benign teratoid elements. The ultrastructure of the omental and peritoneal pigmented nodules confirmed that the lesions consisted of histiocytes phagocytizing massive melanin pigments. Although no melanocytic neoplasm was found in the ovarian cystic teratoma, circumstance suggests that the ovarian, omental, and peritoneal pigmented lesions were secondary reactions to melanin released from the ruptured cystic teratoma.

The sensitivity in detecting human papillomavirus (HPV) by histological observation of koilocytosis, immunocytochemistry, and electron microscopy with reference to the results of Southern blot deoxyribonucleic acid (DNA) hybridization were reviewed in 41 lesions (37 patients) of cervical and vaginal condylomata acuminata and intraepithelial neoplasia. Human papillomavirus DNA was demonstrated in fresh tissues by Southern blot DNA hybridization in all but one lesion of moderate dysplasia (98%). The rate of koilocytosis observed in tissue sections was 80% in condyloma, and ranged from 89-20% in cervical intraepithelial neoplasia (CIN), with steady reduction as the grade of CIN or vaginal intraepithelial neoplasia (VaIN) was higher. The immunocytochemistry for HPV capsid antigens was positive in 80% of condylomata and ranged from 61-0% in CIN or VaIN. The rate declined in inverse proportion to the grade of CIN or VaIN. Electron microscopy of preselected areas containing intranuclear inclusions in paraffin sections of 10 lesions demonstrated HPV-like particles in 90% of the lesions. Although immunocytochemistry and observation of koilocytosis may be useful in detecting HPV in condylomata acuminata and mild dysplasia, their sensitivity was poor in CIN or VaIN of higher grades. Electron microscopy on preselected areas in paraffin blocks showed better sensitivity, presumably due to its ability to detect immature virions.