Pathomorphology of human papillomavirus (HPV) infection of the cervix uteri and vulva

: An infection with Human Papilloma Virus (HPV) is directly associated with the development of the cervical and vulvar carcinomas. The infection should be diagnosed and considered in the choice of therapy. Taking no account of HPV infection in histological pictures may lead to overdiagnosis of Ca"0" (CIS). HPV infection is possible to be recognized--in most cases--in cytological and histopathological studies. Cytological and histopathological studies are the basis for other examination methods. The authors, who have been dealing with HPV problem for 10 years, describe characteristic morphological features of the HPV infection based upon original material accompanied by microscopic documentation. The article describes: the types of condylomas, morphological properties of koilocyte and dyskeratocyte with consideration of electronmicroscopic studies, specific features of the infected epithelium, the notion of koilocytic atypia and atypical condylomas, diagnostic difficulties, differentiation with classic dysplasia, the presence of changes typical for Bowen's disease of the cervix and Bowenoid papulosis on the vulva. Morphological diagnosis of the HPV infection worse--in many cases--confirmed by virusologic studies determining the type of the virus in the tissue. It is the authors' opinion that koilocytic atypia is a special form of the intraepithelial neoplasia (CIN, VIN). They emphasize the contribution of the HPV infection to the prevention of cancer of the uterine cervix and vulva.