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The objective is to extract the extra space to find the malignant area. The image has been observed and extracted with various methodologies to find the exact nuclei of the cancer cells. Koilocytes cells were taken into consideration of analysis and super pixels segmentation. The malignant cells were found out by extracting and eliminating the background space of the cervical image to get a clear picture of the affected cervical cells. The nuclei cells were segmented to get positive and negative values. The original images were extracted by removing the background spaces and the cytoplasm of the cervical region. The squamous and basal cells were determined by eliminating unwanted cytoplasm. The super pixel cells were taken for the analysis. The method was designed the framework with the series of segmentation and extracting the core nuclei to extract the unwanted space to find the malignant area. Stage 0 explains about the cancer cells find out in the surface of the cervix. More invasive cancers are differentiated into four stages. Stage I—if cancer grows beyond the surface of the cervix and the uterus without affecting the outer region i.e., Walls of the pelvis or the vagina’s bottom surface. Stage II describes the cancer cells has been spread beyond the cervix surface and uterus and possibly to nearby tissue. Stage III cancer considered as a severe type of cancer. The cancer cells were spread to the lower part of the vagina and sometime it will stop the urine flow. Stage IV clearly defines the most advanced stage of cervical cancer. It will affect all the organs of the body. The affected cells were extended to the organs of the human body. The detected malignant cells were divided into segmentation. If the segmentation of each frame contains a malignant cell, then it will be marked as positive and if the frame doesn’t have a malignant cell, then it will be marked as negative. By analysing the segmentation and extraction it can be easily find out the number of malignant cells in the region. In our proposed methodology the original image was undergone into various slides of the Pap smear test. By the positive and the negative values of the core nuclei the growth and the severity of the malignant cells can be pictured. Through the results, the treatment can be easily carried out according to the stages of severity.

Introduction: Tongue papillomas are benign epithelial tumors of the tongue lining. It is a precancerous lesion of viral origin caused by the Human papilloma virus (HPV). Objective: To describe the clinical and histological manifestations of a particular type of oral papilloma. Observation: A young woman aged 28 years resident in Siguiri (Guinea), received in consultation for a painless mass on the tongue slow evolving for 6 months duration. There was no notion of mouth bleeding. She had no particular medical and surgical history and negative for retroviral test/HIV test. Examination of the oral cavity found a fungating mass in at Right or Left posterior third of the tongue, painful on contact, sessile and pedunculated and not bleeding on contact and of soft consistency. The excision of the tongue mass was performed under general anesthesia. Biopsy was taken and sent for HPE. The consequences were mild, allowing her to be released 3 days after surgery. Histological examination showed an acanthotic stratified para-keratinized squamous epithelium containing small parts of connective tissue and koilocytes containing connective tissue nuclei reminiscent of papilloma. There was no malignancy cell. Conclusion: The papilloma of the tongue is a benign proliferative lesion characterized by slow and painless growth. I would say early diagnosis and surgical excision should be done to avoid recurrence, contact bleeding and morbidity secondary to mass effect.

Introduction: Seborrheic keratosis-like lesion of the cervix and vagina is a rare lesion and shows similar morphology to vulvar seborrheic keratosis; 3 of the 7 previously reported cases were associated with low-risk human papillomavirus (HPV) type 42. We report a case of seborrheic keratosis-like lesion of the cervix and provide the first description of the cytological features of this lesion. Case Presentation: A woman in her late forties presented with postcoital bleeding. She had a cervical screening test following which she underwent cervical biopsy, endocervical and endometrial curettage, large loop excision of the transformation zone of the cervix, and hysterectomy. Results: The liquid-based cytology preparation showed cohesive groups of mildly atypical squamoid cells with a spindle cell morphology, mildly increased nuclear to cytoplasmic ratio, prominent nucleoli, and occasional nuclear grooves. No koilocytes were identified. Molecular genotyping revealed positivity for HPV type 42. Discussion/Conclusion: This represents the first description of the cytological features of a seborrheic keratosis-like lesion of the cervix, which are distinctive and unusual. Whilst the mild squamous atypia raised the possibility of a low-grade squamous intraepithelial lesion, no koilocytes were identified. The association in our case with a low-risk HPV type, HPV 42, provides further evidence for a role of this HPV type in the pathogenesis of these lesions.

Cytological features of placental site plaques in liquid-based cervicovaginal preparations have been seldom documented in the literature. We present a rare case of endocervical placental site plaque misinterpreted as a low-grade squamous intraepithelial lesion in a liquid-based cytological preparation. A 32-year-old woman with polycystic ovarian syndrome gave birth 7 months previously. After delivery, she was diagnosed with cervical low-grade squamous intraepithelial lesion during routine cytological examination. Cytologically, many atypical cells showed large hyperchromatic nuclei with irregular membranes. The perinuclear cytoplasmic clearing closely resembled koilocytosis. Histologically, the endocervix showed typical histological features of a placental site plaque. Immunohistochemically, the trophoblasts were positive for p63, CD10, and inhibin-α but negative for p16. Based on genotyping, both the cytological and biopsied specimens tested negative for human papillomavirus. We re-examined the liquid-based preparation cytology slides thoroughly and concluded that the atypical cells initially misinterpreted as low-grade squamous intraepithelial lesion were actually trophoblasts. Immunocytochemical staining revealed uniform cytoplasmic inhibin-α expression in the trophoblasts. In summary, we demonstrated that endocervical placental site plaques can mimic low-grade squamous intraepithelial lesions in liquid-based cytological preparations. Immunocytochemical staining results and negative results on human papillomavirus genotyping further support that atypical cells resembling koilocytes are trophoblasts obtained from the placental site plaque.

Introducción: El carcinoma epidermoide de pene se considera una enfermedad rara en países desarrollados, representando el 0.4-0.6% de las neoplasias malignas en los hombres, sin embargo, en los países en vías de desarrollo representa el 10-20% de las neoplasias malignas. El 95% de los casos corresponde a carcinoma epidermoide, los factores de riesgo que destacan son fimosis, tabaquismo e infección por virus del papiloma humano. Objetivo: Describir las características clínicas y patológicas de pacientes con diagnóstico de cáncer de pene. Material y métodos: Se realizó un estudio retrospectivo, retrolectivo y descriptivo de expedientes clínicos físicos y electrónicos de los pacientes atendidos en servicio de Urología y Oncología del Hospital General de México en un periodo de 5 años de enero 2015 a enero 2020. Resultados: Se incluyeron datos de 93 pacientes con edad promedio de 57.87 años (23-86), tabaquismo en el 55.9%. Comorbilidades en el 50%. El grado de escolaridad primaria, secundaria o analfabeta en el 65.6%, 20.4 y 7.5%, respectivamente. Se identificó fimosis en el 74.2%. Los sitios más frecuentes de localización del cáncer fueron Glande, glande-prepucio o cuerpo en el 40.9%, 33.5% y 23.7%, respectivamente. Coilocitosis en el 17.2%. Identificamos invasión linfovascular en el 18.3%, perineural en el 19.4%. Conclusiones: En nuestro hospital contamos con casos de cáncer de pene frecuentemente, está incluido en los 20 principales diagnósticos anuales, en su mayoría de tipo escamoso, moderadamente diferenciado, de presentación ulceroso, estadio T3, estadio clínico N0.

Impaired keratinocyte differentiation has recently been suggested as a key event in equine hoof canker development. Koilocytotic appearance of keratinocytes, one of the most characteristic morphological alterations in hoof canker tissue, is also a common marker for papillomavirus (PV) infection, and bovine PV-1 and/or -2 (BPV-1/2) has previously been detected in equine canker patients. Therefore, the present study aimed to correlate the frequency and severity of koilocytotic keratinocytes with BPV detection in hoof canker samples. Hoof tissue of 5/18 canker-affected horses and 2/6 control horses tested positive for BPV-1/2 DNA using polymerase chain reaction. Thus, no association between the presence of BPV-1/2 papillomaviral DNA and koilocytotic appearance was found. Proteins associated with but not specific for PV infection were also investigated. Using immunohistochemistry, specific adhesion molecules (E-cadherin and β-catenin) and intermediate filaments (keratins 6 and 14) important for intact epidermal barrier function and keratinocyte differentiation were documented in control samples ( n = 6) and in hoof canker tissue samples ( n = 19). Altered expression patterns of intermediate filaments and adhesion molecules were demonstrated in canker tissue, confirming the importance of incomplete keratinocyte differentiation, as well as the crucial role of keratinocyte differentiation in hoof canker.

Evidence from current studies show that squamous cell carcinomas at oral and oropharyngeal sites are distinct and unique, with their own separate etiopathogenesis, treatment, and prognosis. The aim of this work is to correlate p16 immunohistochemical expression with histomorphological features suggestive of HPV infection in oral and oropharyngeal squamous cell carcinoma. A total of 50 consecutive biopsy cases of oral squamous cell carcinoma (OSCC) and 50 consecutive biopsy cases of oropharyngeal squamous cell carcinoma (OPSCC) were evaluated for features suggestive of HPV infection like focal basaloid appearance, nests, and lobules of tumor cells with pushing borders, absence of stromal reaction, central necrosis, focal lymphoepithelial morphology, presence of koilocytes, and non-keratinizing or hybrid morphology. Immunostaining was performed using p16 monoclonal antibody (clone mouse 16P04). Only cases showing a moderate (2+) to high intensity (3+) staining in more than 75% cells were taken as p16 immunopositive. The histological features were correlated with p16 immunopositivity. A total of 18/50 (36%) cases of oral squamous cell carcinoma and 27/50 (54%) cases of oropharyngeal squamous cell carcinoma were p16 immunopositive. On statistical analysis, only nests/lobules with pushing borders were found to have a significant correlation with p16 immunopositivity (P value = 0.0012) for OSCC cases. For OPSCC cases, four histological features namely nests and lobules with pushing borders (P value = 0.0001), focal basaloid appearance (P value = 0.0041), lymphoepithelial morphology (P value = 0.0029), and non-keratinizing/hybrid morphology (P value = 0.0141) had a significant correlation with p16 immunopositivity. Histomorphological features are more helpful in predicting p16 immunopositivity in OPSCC than OSCC.

Introduction Oral squamous papilloma is a benign tumor, but its potential for malignant transformation has yet to be studied. The authors report an unusual case presentation of an oral squamous cell carcinoma (SCC) arising from a squamous cell papilloma (SCP). Case presentation A 61 years old immunocompromised female patient complained of an asymptomatic white mass on the buccal mucosa. The diagnosis of squamous cell papilloma (SCP) was made, and the benign nature of the lesion was confirmed by two biopsies. The lesion suddenly increased in size, and the third biopsy revealed a malignant squamous cell carcinoma (SCC) grade II. At this stage, radical surgical intervention was the treatment of choice, and reconstruction with a combination of the pectoralis major and deltopectoral flaps was performed. Discussion Clinical and histopathological diagnosis of oral squamous papilloma is challenging. Reconstruction of composite head and neck defects is another challenge, especially in elderly and immunocompromised patients. The whole process of diagnosis and progress of the presented case might provide useful knowledge regarding the nature of the lesion and its future management. Conclusion The authors emphasize the need for establishing a clear understanding of potentially malignant oral lesions. Close observation, multiple biopsies, early detection, precise diagnosis, and a multidisciplinary team approach are all of paramount importance.

Human papillomavirus (HPV)-induced invasive cervical squamous cell cancer (SCC) develop via high-grade squamous intraepithelial lesion (HSIL). In contrast to classic thick HSIL, thin HSIL (≤9 cell layers) are poorly documented. This study compares histology, HPV genotypes, and aberrations in 50 cancer genes of 45 thin HSIL to 45 thick HSIL, 20 pT1a SCC, and 40 ≥pT1b SCC. Thin HSIL arose from proliferating reserve cells within endocervical epithelium or immature metaplasia throughout the transformation zone after infection with high-risk HPV genotypes (36/45; 80%), and 20% non-high-risk HPV genotypes compared with 2.5% thick HSIL, pT1a SCC, and ≥pT1b SCC. Thin HSIL were multifocal proliferations with varying epithelial thickness between 1 and 2 to 9 cell layers, with occasional transitions to thick HSIL or concomitant lesions of thick HSIL. Overall, 40% thin HSIL were located distant to and most thick HSIL occurred near or at the squamocolumnar junction. Only 20% thick HSIL showed koilocytosis. All HSIL lacked somatic gene mutations, compared with 30% pT1a and 55%≥pT1b SCC. Overrepresented rare germline variants in the MET, JAK3, and FGFR3 genes occurred in all patient groups. In summary, thin and thick HSIL arose independently of somatic gene mutations. The maturation level of the squamous epithelium at the time of transforming infection determines if a thick HSIL develops directly from HPV-infected proliferating reserve cells via thin HSIL or in stratified glycogenated squamous epithelium via low-grade squamous intraepithelial lesion. These observations raise doubts about the biological relevance of separation into thin and thick HSIL. The oncogenic potential of HPV genotypes but also germline variants may influence the natural history.

Introduction/Background* LIMA1 or EPLIN is a cytoskeleton-associated protein involved in cytoskeleton regulation and dynamics, by inhibiting actin filament depolymerization and cross-linking filaments. The role of LIMA1 has been investigated in several malignant diseases including prostate, esophageal, breast and ovarian cancer. Its expression is often lost or aberrant in tumor cells leading to aggressive phenotypes. The aim of this study was to systematically assess the expression of LIMA1 in cervical cancer. Methodology Immunohistochemical analysis using anti-EPLIN antibody was performed in 22 cases of cervical intraepithelial neoplasia, 14 cases of adenocarcinoma including one case with mucinous and one case with endometrioid adenocarcinoma, 5 cases of adenosquamous carcinoma, 25 cases of squamous cell carcinoma and 11 normal samples. The correlation of LIMA1 aberrant expression and disease progression was performed using the medical records of patients. Clinical samples of normal and tumor tissues were surgically excised, following an informed consent from all participants. Result(s)* The levels of LIMA1 expression were low for healthy specimens, and limited to the cells of the basal membrane. LIMA1 expression showed a slight increase in the cases of intraepithelial neoplasia; however, it was quite low in cells displaying a HPV cytopathic effect (koilocytosis). On the contrary, the LIMA1 levels of both cytoplasmic and cell-membrane staining were significantly increased in the cases of adenocarcinoma and squamous cell carcinoma. Lastly, LIMA1 was highly expressed in undifferentiated, non-keratinizing, squamous cell carcinoma associated with poor prognosis. Conclusion* Our results demonstrate that LIMA1 is differentially expressed not only in normal and cervical cancer tissues, but also in precancerous lesions and malignant cervical neoplasia, highlighting its role in cervical cancer progression and its potential exploitation as a prognostic factor.

A male Holstein-Friesian calf was born with multiple, cauliflower-like, pale pink cutaneous masses on the head and limbs. On histopathological examination, the cutaneous masses were diagnosed as congenital cutaneous fibropapillomatosis. Those lesions involved focal proliferation of sebaceous gland in the dermis. There were no histological findings to suggest bovine papillomavirus infection, such as the presence of intranuclear inclusion bodies, large keratohyalin granules, and koilocytosis. Furthermore, papillomaviral antigens and DNA were not detected by immunohistochemistry and polymerase chain reaction, respectively. These results suggested that there was no association between these cutaneous lesions and bovine papillomavirus infection, and the lesions were considered as harmartomatous changes.

Many genotypes of human papillomaviruses (HPVs) may lead to morphological changes in cells, resulting in various atypical cells, such as multinucleated cells (MNCs) and koilocytes, in the cervix. However, the relationships between the profiles of HPV genotypes and MNCs are not exactly known. Thus, this study comprehensively profiles the HPV genotypes in MNCs using a microdissection method. HPV genotypes and MNCs were detected in 651 cases with an abnormal Pap smear by liquid-based cytology. Specific HPV genotypes were also detected, including HPV16, 34, and 56, which might be associated with MNCs. This result suggests that the high-risk HPV genotypes, such as HPV16 and 56, are associated with the atypical changes in MNC morphology from normal cervical cells. The results also show that MNCs may be a predictor of squamous intraepithelial lesion.

Monsel’s solution has been in use since the end of the 19th century for its valuable property of creating hemostasis in minor disruptions of the epithelium. Its styptic effect was first described by Leon Monsel, a pharmacist in the French army, in a letter dated on October 13, 1852. Containing ferric subsulphate, it is used as a topical hemostatic agent in minor procedures such as biopsies in gynecology, proctology, dermatology, otorhinolaryngology and odontology. A 28-year-old nulliparous woman, with a known history of adenomyosis, had presented for sudden heavy intermenstrual vaginal bleeding. Examination revealed a bleeding Nabothian cyst. Monsel’s solution application helped stop the bleeding. She returned 3 days later with persistent heavy vaginal bleeding. Examination showed active oozing from the Nabothian cyst. A cervical smear and a human papillomavirus (HPV) swab were taken, and vaginal packing was inserted. The cervical smear result was reported as atypical cells, suspicious for malignancy. Colposcopy performed showed a grade 2 acetowhite lesion, suspicious for cervical intraepithelial neoplasia (CIN) III/microinvasive disease. However, punch biopsies of the cervix revealed only CIN I/koilocytosis. The patient was counselled and subsequently underwent a laser cone biopsy, which showed CIN I with clear margins. The discrepant results between the cervical smear and the cone biopsy prompted a review of the cervical smear and cervical histology; and a relook at the chronology of events. The cytological features observed in the initial cervical smear could be explained by the interference from the Monsel’s solution, which was applied just 3 days before the cervical smear. In cases where Monsel’s solution has been used for hemostasis, it is best to delay taking a cervical smear or a biopsy for at least 3 weeks as the histologic effect of Monsel’s solution may persist for up to that duration of time in tissues. J Med Cases. 2020;11(10):324-326 doi: https://doi.org/10.14740/jmc3556

Background and objective: Genital human papillomavirus (HPV) infection is closely linked to cancer of the cervix. The Papanicolaou-stained smear is the primary method for detection of high-risk HPV. This study aimed to identify women at risk of developing cervical precancerous lesions. Methods: This cross-sectional study involved 75 married, non-pregnant women with anogenital warts. Sociodemographic, fertility history, and details of the anogenital wart infection were obtained from all patients through a questionnaire. Pap smear was performed for all patients, and histopathological assessment was done. Results: The age of the patients ranged from 18 to 55 years. The mean (± SD) age of marriage was 22.2 (± 5.77) years, 12 (16%) women gave birth to a child before the age of 18 years. Filiform warts were identified in 33 (44%) patients, while the acuminate type was found in 24 (32%) patients. Flat warts were seen in nine (12%) patients. There was a significant association between the type of wart and recurrence. Severe erosive cervicitis was found in 45 (60%) smears. Moderate cervicitis was observed in 24 (32%) smears, and six (8%) had mild cervicitis. A significant association was found between duration of the genital wart and cervicitis. Twenty percent had atypical squamous cells of undetermined significance. No malignant changes and no koilocytes were identified. Conclusion: Early marriage, unawareness of the risk of anogenital warts, and neglecting regular Pap smears are risk factors for developing cervical cancer.

Canine papillomatosis is mainly attributed to papillomavirus infections. Papillomavirus DNA is also frequently identified in healthy skin, and evidence of high papillomavirus diversity complicates this simplistic view of causality. The aim of this study was to determine how frequently canine papillomas contain papillomavirus DNA and express viral protein, and how these factors correlate to the histology and anatomic location. Fifty-three archived, formalin-fixed samples of canine papillomas and eight samples of other proliferative skin lesions from dogs were included. Samples were re-evaluated histologically, tested for papillomavirus L1-antigen using immunohistochemistry, and for papillomavirus DNA with PCR assays and molecular sequencing. Most papillomas from haired skin contained papillomavirus DNA (96%) and antigen (92%). Of oral papillomas, 88% were positive for both papillomavirus DNA and antigen. Approximately 50% of non-papilloma proliferations and papillomas from eyelid/conjunctiva specimens contained viral DNA, but antigen was present in only 12% of eyelid/conjunctiva papillomas and in none of the non-papilloma proliferations. The presence of viral antigen was highly correlated with histological indicators of viral infection, including intranuclear inclusions, koilocytes, cytoplasmatic vacuolation and dysplasia. The viruses found were mainly CPV1 and CPV2. CPV1 dominated in oral infections, while CPV2 dominated in cutaneous endophytic papillomas. Co-infections with CPV1 and CPV2 accounted for about 20% of all detected infections. These results support a role for papillomaviruses in canine cutaneous and oral, exophytic and endophytic papillomas and support previously raised doubts about their role in squamous papillomas from eyelid/conjunctiva specimens.

Background: Cervical cancer ranks the fourth most common cancer among women worldwide and the eighth cancer overall. It is considered as one of the most preventable malignancies, and can be controlled through screening and Pap smears. Objectives: To explore the demographic and clinical characteristics of a sample of Iraqi patients who were referred to the National Cancer Research Center of the University of Baghdad for Pap smear test. Patients and methods: The study enrolled 175 female participants who were subjected to clinical examination and Pap smear tests. A questionnaire was filled for each patient on which demographic and clinical variables were recorded. Cellular specimens were collected, fixed, stained by Papanicolaou stain and examined cytologically. The corresponding cytological findings were correlated with the studied variables and tabulated accordingly.Results: 60% of the 175 women were housewives, 40% got married before the age of 20 years, 35.4% had used contraceptive pills and 10.3% were nulliparous. The mean ages at marriage, pregnancy and first child birth were 20.2, 22.0 and 23.0 years respectively. On clinical examination, cervical erosions were obviously apparent in 41.7% of the cases and genital warts were noted in only one case (0.6%), while koilocytotic cellular atypia was observed in 4.0%. Pap smears revealed infections with Moniliasis and Trichomonas Vaginalis in 16.5% and 1.1% respectively. Atypical metaplastic changes, AGUS (atypical glandular cells of uncertain significance) and ASCUS (atypical squamous cells of undetermined significance) were displayed in 21.1%, 5.7% and 22.3% respectively. Diagnoses of CIN I (LSIL) (cervical squamous intraepithelial neoplasia 1 - low-grade squamous intraepithelial lesion), CIN II and CIN III (HSIL) (high-grade squamous intraepithelial lesion) were reported in 26.8% and 2.3% respectively. Among patients with cervical erosions, the Pap smear findings illustrated more pronounced cellular changes consistent with atypical squamous metaplasia, AGUS and ASCUS (43.8%, 19.2% and 45.2% respectively). On the other hand, LSIL, kiolocytotic atypia and HSIL in these cases were registered in 15.1%, 6.8% and 1.3% respectively. Conclusions: The demonstrated young ages at marriage, pregnancy and childbirth of the examined patients, reflecting the early onset of sexual reproductive activities, and the associated cellular changes urge the necessity for promoting public awareness on the significance of Pap smear screening among Iraqi females. The Bethesda system facilitates easier interpretation of the results; thus fostering the communications between the examining pathologists and the gynecologists.

Background The presence of human papilloma virus in benign oral lesions has been studied by different techniques obtaining extremely variable results. The objective of this study was to determine the presence of human papillomavirus in 83 cases of benign hyperplastic epithelial oral lesions. Material and Methods Eighty-three oral lesions with clinical or histopathological features suggestive of HPV infection were retrieved from the files of four oral pathology services. Demographic data were obtained from patient´s medical charts. All cases had available clinical image, H&E preparations and paraffin blocks with enough tissue for HPV detection by in situ hybridization, and immunohistochemical reactions for Ki67. Results Episomal positivity for wide spectrum HPV was observed in 24% of the cases; most of them (70%) HPV 6/11 positive. HPV 16/18 was not detected. Condyloma acuminatum was the most common lesion associated with HPV (75%), followed by verruca vulgaris (15%), squamous papilloma and multifocal epithelial hyperplasia, 5% each. Koilocytes were identified in all the HPV positive cases. Ki67 showed an abnormal proliferation pattern in 90% of the HPV positive cases; most of them (70%) showing groups of proliferating cells in focal superficial regions, and in 20% positivity was seen almost in the whole thickness of the epithelium. HPV negative cases showed Ki67 positive cells restricted to the basal layer. Conclusions Regarding oral lesions associated with HPV, condyloma is the most common lesion expressing low-risk subtypes. The etiology of squamous papilloma remains controversial as HPV was found in 1.9% of the cases. The identification of koilocytes and the pattern of expression of Ki67 reflect HPV infection and are helpful for classification. Papillary oral lesions not associated to HPV deserve further studies to better clarify its etiology. Key words:Human papillomavirus, condyloma, papilloma.

Background: Condylomata Acuminata (CA) is a sexually transmitted disease caused by the Human Papilloma Virus (HPV) type-specific and may be simultaneously co-infected with other HPV types associated with malignancy. Purpose: To differentiate between CA and histopathological of malignancy by immunohistochemistry. LiteratureReview: CA refers to benign epidermal proliferation caused by the HPV types 6 and 11, but co-infection with high- risk HPV types are common. The clinical presentation of CA can’t differentiate between benign or preneoplastik diplasia lesions. Koilocytes considered pathognomonic for HPV lesions, these findings sometimes don’t appear on CA, and histopathology was not accurate, that immunohistochemistry with MIB-1 (Ki-67) and p16 can beused. Conclusion: Immunohistochemistry examination can help differentiate the diagnosis between malignancy or non- malignancy in the case of CA.

Introduction: Condyloma acuminata that is also known as genital warts are one of the most common sexually transmitted that caused by infection of Human papillomavirus (HPV). Persistent infection of Low Risk (LR) or High risk (HR) HPV is a risk factor for progress into benign or malignant cancer. The objective is to analyze distribution of genotype LR-HPV and HR-HPV at condyloma acuminata in anogenital region. Methods: A cross sectional study using were 36 lesions from men and women of condyloma acuminata patients. All subject signed the informed consent and ethic obtained from our institution, number 382/Panke.KKE/V/2016. The specimen was used to histopathological examination and to identified 40 genotypes of HPV using a reverse line blot assay.Results: The All patients were diagnosed as condyloma acuminata, some with focus dysplasia and koilocytosis. All patients were positive for HPV, including LR-HPV were HPV 6, 11, 42, 54, 61, 81,87,89 and HR-HPV were HPV 18, 26, 45, 51, 52, 66, 67, 68B, 69, 82. The single infection of LR-HPV was 44.4%, multiple infection LR/LR-HPV was 13,9% and the multiple infection of LR/HR-HPV was 41.7%. The LR-HPV infected 70,6% and HR-HPV infected 29,4%. Conclusion: LR-HPV is the major infection of condyloma acuminata, in single infection or multiple infection with HR-HPV. The most common infections were HPV 11, followed by HPV 6, HPV 18, HPV 51, and HPV 82. The determination of genotype of HPV can be used to predict the malignant transformation.

Psychological stress is an important factor involved in disease manifestations of human papillomavirus (HPV) infection, and it can participate in HPV-associated carcinogenesis. The impact or effect which stress can have (exert) depends on a person’s genetic pool, experiences and behaviors. Due to inconsistencies in some study results, this issue remains a subject of research. Concerning the course of HPV manifestations, it has been observed that a higher number of life stressors in at least the previous 6 months, the absence of social support and the types of personal coping mechanisms employed, all influence HPV progression. In women with cervical dysplasia, a connection between greater stress experiences and dysregulation of specific immune responses has been observed. Once HPV enters a cell via the α6 integrin there are three possible sequences: latent infection, subclinical infection, and clinically manifest disease. HPV proliferation in differentiated epithelial cells induces morphologically cytopathic changes (koilocytosis, epidermal thickening, hyperplasia, hyperkeratosis). Oncogenic transformation requires the integration of the virus genome into the host genome. In doing so, DNA in the E1 region of E2 breaks down, leading to transcription disorders of E6 and E7. For the formation of irreversible malignancy, the following sequence is necessary: initial expression of E6 and E7 genes followed by suppression of apoptosis and the stabile expression of E6 and E7 proteins that protect transformed cells from apoptosis. A successful immune response is characterized by a strong, local cell-mediated immune response. Several factors are important for the regression of HPV manifestation/infection, among which is psychological stress which can prolong the duration and severity of HPV disease. Stress hormones may reactivate latent tumor viruses, stimulate viral oncogene expression, and inhibit antiviral host responses. In the regression of HPV infection, increased activity of Th1 cells was observed. However, during psychosocial stress, a decrease in the Th1 type of immune response is seen, and there is a shift towards a Th2 response. Understanding perceived stress and biological changes in stress, as well as the evaluation of immune parameters, gives researchers a better picture of how stress influences HPV infections and how to improve disease management and outcomes.

BACKGROUND Human papillomavirus (HPV) is the main causal factor of cervical carcinoma. HPV 16 is one of the most prominent oncogenic types. We aimed to evaluate the cytomorphometric and morphological alterations caused by HPV 16 in liquid-based cytology (LBC). METHODS The Cobas 4800 HPV system was used for the detecting and typing HPV DNA in cervical specimens. In this study, 30 HPV 16 positive and 30 HPV 16 negative cervical samples were evaluated for micronuclei (MN), nonclassical cytologic abnormalities, and the nuclear-to-cytoplasmic ratio. Nuclear and cellular areas were evaluated using image analysis software and the nuclear-to-cytoplasm ratio was calculated. All analyses were performed blinded to the patients' HPV status. Statistical evaluation was carried out using the χ2 and Fisher test; P-values

Background: Condylomata accuminata (CA) is a sexually transmitted infection caused by the Human Papillomavirus (HPV), which has more than 40 subtypes classified into high and low risks. The incidence of coinfection involving HPVs in genitalia varies between 2%–71%. Coinfection events increase in immunosuppressed patients. Purpose: To know the types of HPV in CA lesions and the risk factors of a high and low-risk HPV coinfection. Case: A 45-year-old woman presented with genital warts appeared three weeks before. The patient had a breast cancer history and undergone chemotherapy. The examination revealed multiple papules with verrucous surface, firm borders, with whitish color around the urethra and on the vaginal wall. Acetowhite test was positive. The biopsy examination showed squamous epithelium arranged to form papils and foci suspected as koilocytes suggesting CA. The Human Immunodeficiency Virus (HIV) rapid test, VDRL (Venereal Disease Research Laboratory) and TPHA (Treponema Pallidum Haemagglutination) examinations showed non-reactive results. The HPV deoxyribonucleic acid (DNA) genotyping test showed positive results for HPV type 56 (High-Risk Genotypes) and HPV type 6 (Low-Risk Genotypes). She was treated with electrosurgery and consulted to the urology department. Discussion: Coinfection of HPVs might cause a persistent HPV infection for a longer duration, as well as the risk of developing into cancerous lesion. The mechanism of high-risk and low-risk HPV coinfection in immunosuppressed individuals might be due to faster replication of the virus or reactivation of a latent infection . Conclusion: Coinfection of 2 types of HPV could happen in immunosuppression condition such as in patient undergone chemotherapy.

Buschke-Lownestein tumor (BLT) or giant condylomata acuminata (GCA) caused by human papillomavirus (HPV). It´s a rare condition, essentially transmitted sexually. The confirmation is histological, after a biopsy of the mass. The treatment is poorly coded, the surgical treatment is the gold standard. The evolution is characterized by recurrences, requiring surgical recovery. Sex education and treatment early condylomatous lesions improves the prognosis of this affection. We present the case of a 50-year-old man, married, with the notion of sexual vagrancy. On clinical examination we found a large, painless, exophytic tumor lesion, budding, irregular at the base of the penis on the ventral side, extending towards the scrotum. This mass has been evolving for 15 years. Examination of the oral and anal mucosa shows no associated lesions. The physical examination did not find inguinal lymphadenopathies. The clinical size of the tumor, about 8cm, was oriented towards a Buschke-Lowenstein tumor. The standard biological examinations were normal. Serologies HIV, chlamydia, syphilitic and hepatitis B and C were negative. Histological examination of the exeresis specimen revealed epitheliomatous hyperplasia. which was made of an acanthosic squiggle coating, papillomatous, overcome by parakeratotic hyperkeratosis. with the presence of koilocytes signalling HPV infection, without signs of malignancy. A wide exeresis has been performed. The evolution has been good without recurrence, with 18 months of hindsight.

Papillomaviruses (PVs) are circular double-stranded DNA virus belonging to Papillomaviridae family. During the infection cycle, PVs translate proteins that can influence cell growth and differentiation, leading to epidermal hyperplasia and papillomas (warts) or malignant neoplasms. Canis familiaris papillomaviruses (CPVs) have been associated with different lesions, such as oral and cutaneous papillomatosis, pigmented plaques, and squamous cell carcinomas (SCCs). Here, we report a clinical case of a mixed bred female dog with pigmented plaques induced by CPV16 (Chipapillomavirus 2) that progressed to in situ and invasive SCCs. Gross and histological findings were characterized, and the lesions were mainly observed in ventral abdominal region and medial face of the limbs. In situ hybridization (ISH) revealed strong nuclear hybridization signals in the neoplastic epithelial cells, as well as in the keratinocytes and koilocytes of the pigmented viral plaques. The full genome of the CPV16 recovered directly from the lesions was characterized, and the phylogenetic relationships were determined. The identification of oncoprotein genes (E5, E6, and E7) by high throughput sequencing (HTS) and their expected domains are suggestive of the malignant transformation by CPV16.

The aim of this study was to evaluate the association between prostate cancer (PCa) and Human papillomavirus (HPV) infection in the Mexican population. We studied 356 paraffin-embedded tissues from unrelated Mexican men with PCa or benign prostatic hyperplasia (BPH), with the latter serving as control. HPV detection was performed by polymerase chain reaction (PCR) using universal primers, and viral genotypes were detected using sequencing or multiplex PCR. Light microscopy analyses enabled the identification of koilocytes in samples subsequently analyzed for HPV detection by in situ PCR and for p16-INK4A expression by immunohistochemistry. The results showed that high risk- (HR) HPVs were detected in 37/189 (19.6%) PCa specimens compared to 16/167 (9.6%) of BHP specimens (odds ratio 2.3; 95% CI= 1.2 to 4.3; p=0.01). These data suggest HR-HPV may play a role in PCa. HPV 52 and 58 were the most frequent genotypes (33 and 17%, respectively) detected in the population studied. Koilocytes were detected in all in situ PCR-HPV-positive samples, representing a pathognomonic feature of infection, and we observed the overexpression of p16-INK4A in HPV-positive samples compared to HPV-negative samples, indirectly suggesting the presence of HR-HPV E7 oncoprotein. These results suggest that HPV infection plays an important role in prostate cancer development.

Context.— Papillary immature metaplasia (PIM) is a known papillary cervical lesion associated with low-risk human papillomavirus (LR-HPV). Objective.— To evaluate additional clinicopathologic features and the HPV genotypes of PIM and discuss the presumptive cell of origin. Design.— A total of 26 PIM cases were evaluated by p16INK4a, cytokeratin (CK) 7, and CK17 immunohistochemical stainings. Human papillomavirus genotyping was performed, by using HPV DNA Chip, HPV polymerase chain reaction (PCR), and real-time PCR. Results.— Histologically, PIM forms either a papillary mass (n = 21 of 26, 81%) or a slightly elevated/flat plaque (n = 5, 19%). All cases contain variable amounts of mucinous epithelia within the lesions. Koilocytosis was identified in 15 of the 26 cases (58%). Sixteen cases (61%) were associated with LR-HPV (types 6, 11, or 42), but 3 cases (12%) with high-risk (HR) HPV (16, 16/18, and 33), 2 cases (8%) with mixed LR- and HR-HPV (6/16 and 11/58), while 2 cases (8%) were negative, but p16INK4a immunostaining showed nonblock positivity in all cases. Eight (31%) had high-grade squamous intraepithelial lesion (HSIL) in the adjacent mucosa, 4 (50%) of which showed direct continuity. Identical HPV subtypes were confirmed in separately microdissected cases from PIM and adjacent HSIL. Most lesions (n = 24, 92%) expressed CK17 (reserve cell marker) in a bottom-heavy pattern and CK7 (squamocolumnar junction [SCJ] marker) in a top-heavy pattern, while most cases of low-grade squamous intraepithelial lesion (LSIL) were negative for both markers. Conclusions.— Our results suggest that PIM is a distinct subset of LSIL showing a productive HPV infection, but PIM involves the transformation zone and is proximal to SCJ, while LSIL is mostly from ectocervix or distal to the SCJ.

Objective The Netherlands converted to high-risk (hr)HPV-based screening in 2017. An increase in referral of hrHPV-positive women with low risk for cervical intraepithelial neoplasia grade 3 or more (CIN3+) is anticipated and reduction of unjustified referrals will have priority. The relevance of koilocytosis in relation to the underlying risk of high-grade CIN in a primary HPV screening setting is unclear. The aim was to investigate whether the risk for CIN3+ differs between hrHPV-positive atypical squamous cells of undetermined significance (ASC-US)/low-grade squamous intraepithelial lesion (LSIL) with or without koilocytosis. Methods Retrospective cohort study, using data from the Dutch national pathology database (PALGA). The population was 1201 hrHPV-positive women with cytological diagnosis of ASC-US/LSIL. Reporting of koilocytosis was assessed as well as detection rates of CIN1 or less, CIN2 and CIN3+ for ASC-US/LSIL cytology stratified by presence or absence of koilocytosis. Crude and adjusted odds ratios were determined. Results Koilocytosis was present in 40.1% of ASC-US and 45.9% of LSIL cases. CIN3+ is significantly less often found when koilocytosis is present (7.8% for hrHPV-positive ASC-US with- vs 15.8% without koilocytosis). For hrHPV-positive LSIL this was 11.7% vs 20.2%. The crude and adjusted odds ratios for CIN3+ was 0.45 for hrHPV-positive ASC-US and 0.52 for hrHPV-positive LSIL. Conclusions The presence of koilocytosis is a negative predictor of CIN3+. The risk of hrHPV-positive ASC-US with koilocytosis is in the same range as hrHPV-positive/cytology negative cases and in a setting of primary hrHPV screening these cases could be followed conservatively by repeat cytology. The results should be confirmed by the first data from the Dutch HPV-based screening programme.

Our aim was to estimate the risk of disease incidence in women with atypical squamous cell of undetermined significance (ASC-US) without histology-proven cervical intraepithelial neoplasia grade 2 or worse (CIN2+) by human papillomavirus (HPV) genotype.Between January 2002 and September 2010, incidence of CIN2+ in 2880 women including 2172 with ASC-US and histology-proven negative and 708 with ASC-US with histology-proven CIN1 was investigated. Baseline HR-HPV status was determined by the hybrid capture II assay (HC2) and HR-HPV genotype by the HPV DNA chip test (HDC). Cumulative incidence and hazard ratios were estimated to explore differences between index data and associations with CIN2+.Of the 2880 women, the HC2 was positive in 1509 women (52.4%) and the HDC was positive in 1563 women (54.3%). The overall agreement between the HDC and HC2 was 97.4%. One hundred ninety (6.6%) patients developed CIN2+. The 5-year cumulative incidence rate of CIN2+ in HPV-16, HPV-31, HPV-52, and HPV-58 were 16.7%, 15.1%, 12.6%, and 12.9%, respectively. On multivariate analysis, being positive in HPV-16 (hazards ratio [HR]=2.431; 95% CI, 1.789-3.332; P0.01), HPV-31 (HR=2.335; 95% CI, 1.373-3.971; P0.01), HPV-52 (HR=1.592; 95% CI, 1.031-2.458; P=0.03), and HPV-58 (HR=1.650; 95% CI, 1.132-2.407; P0.01) were significantly associated with developing CIN2+ compared to being negative for that type.Among women with ASC-US, HPV-16, HPV-31, HPV-52, or HPV-58 positive women may need intensified follow-up as they have the highest risk of becoming CIN2+.

Background: The association of human papilloma viral infection in oral squamous cell carcinoma is well studied in the Western countries, but its correlation with DNA damage in the form of micronuclei (MN) formation, ceased apoptosis or presence of chromosomal abnormalities has not yet been studied. Aim: The aim of this study is to find any possible correlation between human papillomavirus (HPV) infection and cytogenetic damage in the oral malignant and premalignant population of West Bengal. Settings and Design: A total of 104 malignant and 103 premalignant cases were selected along with 200 controls. Methods: The buccal smear samples were Pap stained for the detection of MN, apoptosis frequency and koilocytes. The buccal swab samples were processed for DNA extraction followed by polymerase chain reaction for the detection of HPV DNA. The peripheral venous blood samples were processed for the detection of any chromosomal abnormality, by the method of human leukocyte culture followed by Giemsa staining. Statistical Analysis Used: Correlation analysis using GraphPad Prism software was used in this study. Results: About 34.6%, 42.3% and 6.73% of malignant and 6.79%, 3.88% and 20.38% of premalignant cases showed the presence of HPV DNA, koilocytes and apoptosis, respectively. The difference between the MN frequencies of premalignant and malignant oral lesions with the control group is significant with respect to various risk factors (P < 0.05). One percentage of malignant cases showed the presence of chromosomal break. Conclusion: A considerable percentage of malignant cases showing the presence of koilocytes and viral DNA may indicate the effect of HPV infection leading to the malignancy, which can be correlated with the MN and apoptosis frequency.

Purpose: Oral epithelial dysplasia (OED) occurs on exposure of epithelial cells to carcinogens and genetic alteration. Once the reversible cell damage is surpassed, cells either undergo apoptosis or transform into malignancy, chiefly oral squamous cell carcinoma (OSCC). Progressive accumulation of genetic errors (including mutations in TP53 and CDKN1A) is associated with the initiation and progression of potentially malignant oral lesions toward frank malignancy. The present study attempted to correlate the immunohistochemical expression of CDKN1A and TP53 with increasing severity of OED along with increased aggressiveness of OSCC as reflected in the clinicopathologic variables. Materials and Methods: Tissue sections from forty biopsy-proven cases of OED and OSCC were stained with anti-TP53 and anti-CDKN1A mouse monoclonal antibodies. One hundred cells in each case were counted under high power magnification. Results: Poorly differentiated OSCC showed the highest TP53 expression (mean = 70.285), with least expression seen in mild dysplasia (mean = 22.125) (P < 0.001). Higher TP53 count was seen in cases with margin involvement, without recurrence and lymph node involvement and in cases which died of disease. CDKN1A expression was seen only in five cases and that too focally in the cytoplasm, thereby warranting removal of analysis of CDKN1A positivity from the study. Conclusion: The expression of TP53 in OED highlights its role in initial carcinogenesis. Although the role of CDKN1A in the cell cycle has been documented, its relationship to various clinical and pathological variables of OSCC and its different treatment modalities could not be adequately assessed.

Human papillomavirus induced cervical cancer is the fourth most prevalent malignancy affecting females globally. Over the past two decades scientific information unveiled an increasing role for the virus in the pathogenesis of malignancies developing from the mucosal surfaces of the oropharynx. It is feasible to postulate that we may be in the beginning of a global pandemic of oropharyngeal cancer if the mode of transmission of the virus is taken into account. The main goals of this manuscript are to present a brief summary of the mechanisms of human papillomavirus induced malignant transformation, provide guidelines for the microscopic diagnosis of high risk human papillomavirus involvement in mucosal biopsies and highlight the implications thereof in cancers of the mucosal surfaces of the head and neck.

Condylomatous, or warty squamous cell carcinoma (SCC) of the uterine cervix, is a rare variant of invasive SCC. Here, we describe a case of aggressive condylomatous SCC of the uterine cervix. A 43-year-old woman was monitored for 3 years for suspected low-grade squamous intraepithelial lesion. A whitish papillary mass occupied the cervix, and the colposcopic diagnosis was condyloma acuminatum. A cervical biopsy revealed papillary proliferating thick squamous epithelium, which consisted of koilocytes and atypical cells with enlarged nuclei. Hysterectomy specimens showed a thick layer of atypical squamous epithelium with koilocytosis invading the stroma. Immunohistochemistry revealed negative p16 expression. Hysterectomy specimens tested positive for low-risk human papillomavirus type 6, but negative for other high-risk human papillomavirus types. The bilateral pelvic and para-aortic lymph nodes were positive for metastases. In spite of adjuvant chemotherapy, the case relapsed with multiple lymph nodes and lung metastases shortly after the operation.

Context.— Persistent infection with high-risk human papillomavirus (hrHPV) is the major cause of cervical cancer. The effect of HPV infection patterns on cytologic detection of cervical lesions is unknown. Objective.— To determine the effect of HPV infection patterns on the sensitivity of cytologic detection of high-grade cervical lesions. Design.— Papanicolaou tests from 257 women with biopsy-confirmed, high-grade squamous intraepithelial lesions were analyzed with respect to HPV infection patterns. Results.— Among 257 biopsy-confirmed, high-grade squamous intraepithelial lesion cases, the preceding cytology showed 20 cases (8%) were benign; 166 cases (65%) were low-grade cervical lesions, including atypical squamous cell of undetermined significance and low-grade squamous intraepithelial lesions; and 71 cases (28%) were high-grade cervical lesions, including atypical squamous cells cannot rule out high-grade squamous intraepithelial lesion (atypical squamous cell–high), atypical glandular cells, and high-grade squamous intraepithelial lesions. In 236 cases tested for HPV, those exhibiting low-grade cervical lesions on cytology were often associated with coinfections of mixed hrHPV genotypes (31 of 40; 78%) or non-16/18 hrHPV (75/103; 73%), compared with single-genotype infections of HPV-16 (33 of 62; 53%) or HPV-18 (2 of 6; 33%) (P = .001). In contrast, high-grade cervical lesion cytomorphology tended to associate with the single-genotype infection of HPV-16 (20 of 62; 32%) or HPV-18 (3 of 6; 50%), compared with non-16/18 hrHPV (25 of 103; 24%) or multigenotype infection (8 of 40; 20%) (P = .01). Conclusions.— Our findings suggest that multigenotypic or non-16/18 hrHPV infections often produce deceptive lower-grade cytomorphology, which could result in underdiagnosis and delay of treatment. The HPV infection patterns may offer unrecognized benefit beyond HPV genotyping and should be considered during clinical risk evaluation of women with lower-grade cytology.

The aim of this study was to investigate the clinical performance of high risk (HR) HPV E6/E7 mRNA assay in detecting cervical high-grade intraepithelial neoplasia and cancer among women with atypical squamous cells of undetermined significance (ASCUS) Papanicolaou (Pap) smears. A total of 160 patients with ASCUS who underwent HR-HPV DNA assay, HR-HPV E6/E7 mRNA assay and colposcopy biopsy at Third Affiliated Hospital of Zhengzhou University, China, from December 2015 to March 2017, were enrolled. Logistic regression analysis was used to evaluate the relationship between pathological results with clinical biologic factors. Univariate analysis showed that the qualitative results of HR-HPV DNA, qualitative results of HR-HPV E6/E7 mRNA and expression levels of HR-HPV E6/E7 mRNA were risk factors of high-grade cervical intraepithelial neoplasia (CIN) and cervical cancer (all P

In Iran, human papillomavirus (HPV) vaccination is not currently included in the national vaccination program and there are no comprehensive approaches to cervical screening program. Regional data on distribution of HPV types in women is important to predict the impact of current HPV vaccines. Although several studies on distribution of HPV types in cervical precancer and cancer have been conducted in Iran, in most of them HPV positive samples were subjected to specific-primer genotyping (mainly 16 and 18), and leaving the other HPV genotypes almost undetermined. Therefore, the present study aimed to investigate the distribution of HPV types in cervical neoplasia from West and Northwest of Iran. A total of 112 women with atypia, cervical intraepithelial neoplasia, and invasive cervical cancer were included. A PCR assay was performed in all samples to detect the presence of the HPV genome using the GP5+/6+ L1 consensus primer set. All HPV positive samples were subjected for sequencing. In overall, HPV prevalence was 20% in atypica, 44.5% in cervical intraepithelial neoplasia I, 92.3% in cervical intraepithelial neoplasia II-III, and 98.2% in invasive cervical cancer. The most frequent HPV type was HPV 16 (79.2%), which was followed by HPV types 18, 6, and 33 at the frequencies of 6.5%, 5.1%, and 2.7%, respectively. The least HPV types were found to be 31, 45, 53, 58, and 66. In conclusion, this study shows that the current HPV vaccines could have great impact to reduce the burden of cervical cancer in Iran.

Aim The programmed death 1/programmed death 1 ligand (PD-1/PD-L1) pathway can decrease the immune clearance effects of antigen-presenting cells and T lymphocytes to promote immune evasion of cervical cancer cells. However, the effects of this pathway on cervical intraepithelial neoplasia (CIN) progression and squamous cell carcinoma (SCC) metastasis are not clear. We herein investigated whether human papillomavirus infection could affect PD-1 and PD-L1 expression in CIN, and whether their expression is associated with CIN progression and SCC metastasis. Methods We collected paraffin-embedded samples from two cohorts of patients: (i) CIN samples from cohort I (40 women who tested positive or negative for high-risk human papillomavirus [HR-HPV] with grades 0, I, and II–III CIN); and (ii) paired primary and metastatic tumor samples from cohort II (20 SCC patients with or without metastasis). Immunohistochemistry was used to detect expressions of PD-L1 in tumor cells and PD-1 in tumor-associated macrophages and tumor-infiltrating lymphocytes. We also measured P16INK4a expression and interferon-γ levels in the cervical tissues. Results The most common HPV type seen in both cohorts of patients was HPV16, followed by HPV18. Increase in PD-L1 and PD-1 expression was positively correlated with HPV-positivity, increase in CIN grade, and tumor metastasis. Furthermore, upregulation of the PD-1/PD-L1 pathway was associated with decreased expression of the pro-inflammatory cytokine, interferon-γ and increased expression of P16INK4a. Conclusion Expression of PD-L1 and PD-1 could be used as clinical prognostic biomarkers for evaluating CIN and cervical cancer because of its positive correlation with CIN progression and tumor metastasis.

Aim To examine the effect that human papillomavirus (HPV) vaccination has had in Akita Prefecture, by comparing cervical cytology results from women aged 20–24 years with or without HPV vaccination. Methods We examined cervical cytology results from 2425 subjects who underwent cervical cancer screening under the jurisdiction of the Akita Foundation for Healthcare between January 2014 and October 2016. We compared the prevalence of cytologic abnormalities among women aged 20–24 years with or without HPV vaccination. Results The rate of atypical squamous cells of undetermined significance (ASC-US) or worse was 0.242% (1/413) with HPV vaccination, and 2.04% (41/2012) without HPV vaccination. Overall, the prevalence of abnormal cytology results was significantly lower in women aged 20–24 years who had received an HPV vaccination than in those who had not (P = 0.011). The reduction in the rate of abnormal cervical cytology results by HPV vaccination was 88.1%. Conclusion Within a 4-year–5-year period following vaccination, women aged 20–24 years who received an HPV vaccination had significantly lower rates of abnormal cervical cytology results than those who did not receive the vaccine.

Papillomaviruses (PVs) are small, non-enveloped DNA viruses that cause mucocutaneous tumours including squamous cell carcinoma (SCC) in man. In animals, evidence supports a causal role for PVs in the develop- ment of cutaneous and oral SCC in some species. In reptiles, three cases of papilloma or fibropapilloma have been associated with PV infection, but no association has been reported to date with SCC. Two cases of cutaneous epithelial tumours, multiple papillomas in a spiny-tailed lizard (Uromastyx acanthinura) and SCC in a Dumeril’s boa (Acrantophis dumerili), were investigated by polymerase chain reaction. PV DNA was amplified from samples of both lesions. Typical microscopical features suggestive of PV infection (e.g. the presence of koilocytes) were observed in the lesions from the spiny-tailed lizard. This is the first report of an association between PV and SCC in reptiles. Further studies are needed to better clarify the role of PVs in these species and to characterize the PV strains involved.

Here we describe the histological lesion of a viral fibro-papilloma in a hedgehog. After surgical removal from maxilla, the solitary swollen mass was round to oval, yellowish with rough surface and measuring 6×3×2mm approximately. The tumor mass was submitted to the laboratory of pathology, college of veterinary medicine, Kyungpook National University for pathological diagnosis. Pathological examination of the tumor was established, the tumor was described grossly and sample was trimmed, sectioned and routinely prepared for histopathological evaluation. The tumor mass was diagnosed as viral fibro-papilloma, as the histological picture showed characteristic features of warts caused by papillomaviruses. The tumor characterized by thickening of the stratum spinosum (acanthosis) and basale, koilocytosis, intra-nuclear inclusion bodies in keratinocytes and fibrosis of submucosa. Further, viral inclusion bodies were demonstrated by Machiavello stain giving red color to the nuclei. No lymphocytes that responsible for regression of the wart could be detected, suggesting the poor possibility of spontaneous regression of the tumor. Papillomatosis is a disease of young animals, but in our case the infected Hedgehog was 5 years old, that maybe due to an impaired immune system, which is also shown by absence of lymphocytes. To the best knowledge of the author, this case presents the first report of viral fibropapillomatosis in Hedgehog.