Role of histological findings and pathologic diagnosis for detection of human papillomavirus infection in men

Abstract

Early HPV infection in males is difficult to detect clinically and pathologically. This study assessed histopathology in diagnosing male genital HPV. External genital lesions (n = 352) were biopsied, diagnosed by a dermatopathologist, and HPV genotyped. A subset (n = 167) was diagnosed independently by a second dermatopathologist and also re-evaluated in detail, tabulating the presence of a set of histopathologic characteristics related to HPV infection. Cases that received discrepant diagnoses or HPV-related diagnoses were evaluated by a third dermatopathologist (n = 163). Across dermatopathologists, three-way concordance was fair (k = 0.30). Pairwise concordance for condyloma was fair to good (k = 0.30–0.67) and poor to moderate for penile intraepithelial neoplasia (k = −0.05 to 0.42). Diagnoses were 44–47% sensitive and 65–72% specific for HPV 6/ 11-containing lesions, and 20–37% sensitive and 98–99% specific for HPV 16/18. Presence of HPV 6/ 11 was 75–79% sensitive and 35% specific for predicting pathologic diagnosis of condyloma. For diagnosis of penile intraepithelial neoplasia, HPV 16/18 was 95–96% specific but only 40–64% sensitive. Rounded papillomatosis, hypergranulosis, and dilated vessels were significantly (P<0.05) associated with HPV 6/11. Dysplasia was significantly (P= 0.001) associated with HPV 16/18. Dermatopathologists’ diagnoses of early male genital HPV-related lesions appear discordant with low sensitivity, while genotyping may overestimate clinically significant HPV-related disease. Rounded papillomatosis, hypergranulosis, and dilated vessels may help establish diagnosis of early condyloma.

Distribution Genotype High Risk (HR) And Low Risk (LR) Human Papillomavirus (HPV) at Condyloma Acuminata

“…The presentation of dysplasia base on the histopathological finding was associated with increased infection of HPV 16 and HPV 18, while the rounded papillomatosis, hypergranulosis, and dilated vessels were associated with HPV 6 and HPV 11. 19 The ages of these patients were 20, 22, 26, 42, and 44 years old and infected with HR-HPV and LR-HPV were each 3 patients. Patients diagnosed as condyloma acuminata with a focus on dysplasia and infected by HR-HPV should be monitored to determine the progression of the disease to malignancy.…”

Koinfeksi Sifilis Sekunder, <i>Condyloma Acuminata</i> dan <i>Human Immundeficiency Virus</i> (HIV) pada Pria Homoseksual

“…25 Pemeriksaan histopatologi pada condyloma acuminata akan menampakkan gambaran papilomatosis, akantosis, rete ridges yang memanjang dan menebal, parakeratosis dan koilositosis. 26 Pada pasien ini didapatkan lesi berupa papul verukosa multipel dengan hasil positif pada tes asam asetat 5%. Diagnosis condyloma acuminata ditegakkan berdasarkan anamnesis pasien yang merupakan homoseksual, riwayat berhubungan seks anal tanpa pengaman, pemeriksaan fisik berupa papul verukosa multipel pada regio perianal dan genitalia, serta hasil positif pada tes asam asetat 5%.…”

Anogenital HPV

“…HPV 16-18 are the most common high risk types and can be found isolated or with HPV 6-11 [1,13,14]. The HR-HPV types, most often HPV 16 and 18, are considered to be the primary etiologic agents for cervical cancer and precancerous lesions in women (CIN, VIN, VaIN) [15]. HPV 16 is the main virus type to be associated with the development of VAIN.…”

“…HPV 16 is more prevalent in Europe and North America, HPV 31 is more prevalent in South/Central America, HPV 33 and 45 are more prevalent in Africa and HPV 52 and 58 are more prevalent in Asia [17]. In male anogenital area, HPV is responsible for a subset of squamous cell carcinomas and associated precursor lesions (penile intraepithelial neoplasia, Bowenoid papulosis, erythroplasia of Queyrat (EQ)) [15]. The most typical locations in women are the external genitalia, but lesions can also be in the cervix and labia minor.…”

“…Rete ridges tend to be elongated and point inward toward the center of the wart, and the dermis will often display an increased vascularization with the presence of thrombosed capillaries [14]. Cytoplasmic vacuolization is speciic for condyloma when located within deeper portions of the epidermis such as the stratum spinosum, given that the upper portions of the epithelia of mucosal surfaces normally have some degree of cytoplasmic vacuolization already [15].…”