A convoluted aceto-white lesion was observed by colposcopy on the uterine cervix of 19 patients. A search for specific types of papillomavirus was undertaken in these lesions which proved histologically to be a vertical association of CIN in the lower strata of the squamous epithelium and typical condyloma in the uppermost layers. Previous cell samples correlated with histology in only 11 out of the 19 cases, and were not therefore an accurate predictor of histologic findings. However 16 out of our 19 cases had sufficient cellular changes to warrant colposcopy and biopsy. Papillomavirus capsid antigen was detected by peroxidase-antiperoxidase staining technique in 12 out of the 19 cases (63.1%). In situ hybridization using biotinylated HPV-16 DNA probes was positive in 13 out of 18 cases (72.2%). Southern blot hybridization gave the typical PstI pattern of HPV-DNA in 8 out of 9 cases examined. The detection of HPV-DNA and HPV capsid antigen was particularly high in this "convoluted" cervical lesion, suggesting that the virus remains biologically active. It may therefore be assumed that this lesion represents a particular phase of the disease process in which early gene function and late gene expression of the viral genome are markedly manifested. Furthermore, this lesion may well represent a link between the early manifestation of HPV infection (condyloma) and CIN, which constitute a morphologic continuum initiated by papillomaviruses.

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http://dx.doi.org/10.1002/ijc.2910410410DOI Listing

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