HPV low grade intraepithelial lesion LSIL: many koilocytes
Drs. Prolla and Diehl's INTERESTING CASE OF THE MONTH August 2001 caseA answer

Koilocytes 500x Pap staining, perinuclear cavitation and nuclear abnormalities

Koilocytes 500x Pap staining, perinuclear cavitation and nuclear abnormalities

Empty (anucleated) koilocytes 500x Pap staining

Koilocytes 200x Pap staining, perinuclear cavitation and nuclear abnormalities

Koilocytes high power view of previous image 500x Pap staining

Koilocytes 200x Pap staining, perinuclear cavitation and nuclear abnormalities

Koilocytes, high power view of previous image500x Pap staining

Koilocytes 500x Pap staining, perinuclear cavitation and nuclear abnormalities

Additional images:

Atypical highly keratinized squamous cells (atypical parakeratosis) 500x Pap staining

Koilocytes 500x Pap staining, perinuclear cavitation and nuclear abnormalities

Large amphophilic koilocytes 500x Pap staining

Large abnormal amphophilic squamous cell 500x Pap staining

Large multinucleated abnormal squamous cell, 500x Pap staining

Koilocytes, perinuclear cavitation and nuclear abnormalities 500x Pap staining

Koilocyte 500x Pap staining, large empty koilocyte

Koilocytes 500x Pap staining, perinuclear cavitation and nuclear abnormalities, some large bare abnormal nuclei

Koilocytes 500x Pap staining, perinuclear cavitation and nuclear abnormalities

Koilocytes 500x Pap staining, perinuclear cavitation and nuclear abnormalities

HPV lesion ~ nuclear and cytoplasmic changes are consistent with LSIL. Koilocytes: note that in addition to perinuclear cavitation ( with well defined borders), nuclear abnormalities as seen here are required to make an interpretation of LSIL. "Parakeratosis" is a descriptive term used for abnormal keratinization of the cytoplasm. Very large cells with multinucleation are frequent in LSIL.


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