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ThinPrep pap smear with group of normal cervical cells on left and HPV-infected cells showing features typical of koilocytes: enlarged (x2 or x3) nuclei and hyperchromasia.

A Koilocyte is a squamous epithelial cell that has undergone a number of structural changes, which occur as a result of infection of the cell by human papillomavirus.

Koilocytosis or koilocytic atypia or koilocytotic atypia are terms used in histology and cytology to describe the presence of koilocytes in a specimen.^[1]

Koilocytes may have the following cellular changes:

Nuclear enlargement (two to three times normal size)
Irregularity of the nuclear membrane contour
A darker than normal staining pattern in the nucleus, known as Hyperchromasia
A clear area around the nucleus, known as a perinuclear halo.

Collectively, these types of changes are called a cytopathic effect; various types of cytopathic effect can be seen in many different cell types infected by many different types of virus.^[2]^[3]

When examining cytologic specimens, mild koilocytosis is characteristic of ASC-US (atypical squamous cells - undetermined significance). A more undifferentiated koilocyte, possessing a more hyperchromatic and enlarged nucleus, and a higher degree of cytoplasmic clearing with a discernible peripheral rim favor an interpretation of LSIL (low-grade squamous intraepithelial lesion).^[1]^[2]

Koilocytes may be found in potentially precancerous cervical, oral and anal lesions.^[3]

InterpretationEdit

These changes occur in the presence of human papillomavirus and occasionally can lead to cervical intraepithelial neoplasia, and if left untreated some may eventually progress to malignant cancer.

ReferencesEdit

^ ^a ^b Nucci MR, Oliva E., ed. (2009). Gynecologic pathology: A volume in the series - Foundations in diagnostic Pathology. Elsevier Churchill Livingstone. ISBN 978-0-443-06920-8.
^ ^a ^b DeMay, Richard M. (2007). Practical Principles of Cytopathology Revised. American Society for Clinical Pathology. ISBN 0-89189-549-3.
^ ^a ^b Krawczyk E, Suprynowicz FA, Liu X, et al. (September 2008). "Koilocytosis: a cooperative interaction between the human papillomavirus E5 and E6 oncoproteins". Am. J. Pathol. 173 (3): 682–8. doi:10.2353/ajpath.2008.080280. PMC 2527066. PMID 18688031.

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1. 陰茎癌：臨床症状および診断 carcinoma of the penis clinical presentation and diagnosis

English Journal

HPV16 genotype, p16/Ki-67 dual staining and koilocytic morphology as potential predictors of the clinical outcome for cervical low-grade squamous intraepithelial lesions.

Vrdoljak-Mozetič D1, Krašević M, Verša Ostojić D, Štemberger-Papić S, Rubeša-Mihaljević R, Bubonja-Šonje M.
Cytopathology : official journal of the British Society for Clinical Cytology.Cytopathology.2015 Feb;26(1):10-8. doi: 10.1111/cyt.12121. Epub 2013 Nov 21.
OBJECTIVE: To evaluate the association of human papillomavirus (HPV) 16 and non-16 genotype, p16/Ki-67 dual staining and koilocytosis and their role in the prediction of the clinical outcome of low-grade squamous intraepithelial lesion (LSIL) cytology.METHODS: One hundred and fifty-five patients wit
PMID 24261348

Correlation between squamous cell carcinoma of the lung and human papillomavirus infection and the relationship to expression of p53 and p16.

Fan X1, Yu K, Wu J, Shao J, Zhu L, Zhang J.
Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine.Tumour Biol.2014 Dec 28. [Epub ahead of print]
The number of non-small-cell lung cancer (NSCLC) patients reported as infected with human papillomavirus (HPV) varies among countries and by race and geographical location. Furthermore, the relationship between HPV and the expressions of p53 and p16 remains unclear. A large cohort of NSCLC patients
PMID 25544708

[Prognostic and predictive value of koilocytosis, expression of e6 hpv types 16/18, p16ink4a, p53 in locally advanced squamous cell carcinomas of oral cavity and oropharynx, associated with human papillomavirus].

[No authors listed]
Georgian medical news.Georgian Med News.2014 Nov;(236):48-55.
To determine the predictive and prognostic value of koilocytosis, expression of E6 HPV types 16/18, p16INK4a, p53 in patients with locally advanced HPV-associated squamous cell carcinoma of oral cavity and oropharynx. In biopsy specimens of squamous cell carcinomas of oral cavity and oropharynx from
PMID 25541826

Japanese Journal

細胞診--HPV感染細胞 (子宮頸癌の予防と検査) -- (検査手技・判定の実際)

九島巳樹
臨床検査 55(12), 1425-1428, 2011-11
NAID 40019031112

陰茎癌患者におけるHuman papillomavirus(HPV)感染の検討

湯村寧,服部裕介,納田英幸 [他]
泌尿器科紀要 55(11), 671-673, 2009-11
… We searched for HPV infected cells (Koilocytosis) within the primary lesion of cancer tissue from 78 patients with penile squamous cell carcinoma. … Koilocytosis were detected 55.1% (43 of 78) of patients. … Tumors with Koilocytosis had better differentiation (p=0.0443) and lower grade (better keratinized) in Broders grading system (p=0.0116) than HPV negative tumors. … Our data suggest that the presence of Koilocytosis does not influence prognosis in penile cancer. …
NAID 120001712091