|
|
Line 82: |
Line 82: |
| ==Human papillomavirus== | | ==Human papillomavirus== |
| *Abbreviated ''HPV''. | | *Abbreviated ''HPV''. |
| | | {{Main|Human papillomavirus}} |
| ===General===
| |
| *Sexually transmitted.
| |
| | |
| Note:
| |
| *Some tests can be done on formalin-fixed, paraffin-embedded tissue.<ref name=pmid21128780>{{Cite journal | last1 = Black | first1 = CC. | last2 = Bentley | first2 = HA. | last3 = Davis | first3 = TH. | last4 = Tsongalis | first4 = GJ. | title = Use of a linear array for the detection of human papillomavirus genotypes in head and neck cancer. | journal = Arch Pathol Lab Med | volume = 134 | issue = 12 | pages = 1813-7 | month = Dec | year = 2010 | doi = 10.1043/2009-0592-OAR.1 | PMID = 21128780 }}</ref>
| |
| | |
| ====Associated pathology====
| |
| *Benign:
| |
| **[[Verruca vulgaris]].
| |
| **[[Condyloma acuminatum]].
| |
| **[[Esophagus#Human_papilloma_virus_esophagitis|HPV esophagitis]].
| |
| *Malignant:
| |
| *#[[Uterine cervix|Cervical cancer]] and precursors ([[LSIL]], [[HSIL]]).
| |
| *#Anal cancer and precursors ([[Anus#Anal_intraepithelial_neoplasia|AIN]]).<ref name=pmid21616117>{{Cite journal | last1 = Borget | first1 = I. | last2 = Abramowitz | first2 = L. | last3 = Mathevet | first3 = P. | title = Economic burden of HPV-related cancers in France. | journal = Vaccine | volume = 29 | issue = 32 | pages = 5245-9 | month = Jul | year = 2011 | doi = 10.1016/j.vaccine.2011.05.018 | PMID = 21616117 }}</ref>
| |
| *#[[Vulva|Vulvar cancer]].<ref name=pmid21616117/>
| |
| *#[[Vagina|Vaginal cancer]].<ref name=pmid21616117/>
| |
| *#[[Penis|Penile cancer]].<ref name=pmid21616117/>
| |
| *#[[HPV-associated head and neck squamous cell carcinoma]] - oropharynx (specifically - tonsils, base of tongue).
| |
| *#[[Human papillomavirus-related multiphenotypic sinonasal carcinoma]] (previously known as ''HPV-related carcinoma with adenoid cystic-like features'').
| |
| **Possibly esophageal carcinoma<ref name=pmid21130683>{{Cite journal | last1 = Zhang | first1 = QY. | last2 = Zhang | first2 = DH. | last3 = Shen | first3 = ZY. | last4 = Xu | first4 = LY. | last5 = Li | first5 = EM. | last6 = Au | first6 = WW. | title = Infection and integration of human papillomavirus in esophageal carcinoma. | journal = Int J Hyg Environ Health | volume = 214 | issue = 2 | pages = 156-61 | month = Mar | year = 2011 | doi = 10.1016/j.ijheh.2010.11.001 | PMID = 21130683 }}</ref> - disputed.<ref name=pmid21169053>{{Cite journal | last1 = Iyer | first1 = A. | last2 = Rajendran | first2 = V. | last3 = Adamson | first3 = CS. | last4 = Peng | first4 = Z. | last5 = Cooper | first5 = K. | last6 = Evans | first6 = MF. | title = Human papillomavirus is detectable in Barrett's esophagus and esophageal carcinoma but is unlikely to be of any etiologic significance. | journal = J Clin Virol | volume = 50 | issue = 3 | pages = 205-8 | month = Mar | year = 2011 | doi = 10.1016/j.jcv.2010.11.015 | PMID = 21169053 }}</ref>
| |
| | |
| ====Oncocytic types====
| |
| Known as "high risk" types; this grouping includes:<ref name=pmid22312235>{{Cite journal | last1 = Ntova | first1 = CK. | last2 = Kottaridi | first2 = C. | last3 = Chranioti | first3 = A. | last4 = Spathis | first4 = A. | last5 = Kassanos | first5 = D. | last6 = Paraskevaidis | first6 = E. | last7 = Karakitsos | first7 = P. | title = Genetic Variability and Phylogeny of High Risk HPV Type 16, 18, 31, 33 and 45 L1 Gene in Greek Women. | journal = Int J Mol Sci | volume = 13 | issue = 1 | pages = 1-17 | month = | year = 2012 | doi = 10.3390/ijms13010001 | PMID = 22312235 }}</ref>
| |
| *HPV 18 - predominantly adenocarcinoma.<ref name=pmid15551313>{{Cite journal | last1 = De Boer | first1 = MA. | last2 = Peters | first2 = LA. | last3 = Aziz | first3 = MF. | last4 = Siregar | first4 = B. | last5 = Cornain | first5 = S. | last6 = Vrede | first6 = MA. | last7 = Jordanova | first7 = ES. | last8 = Fleuren | first8 = GJ. | title = Human papillomavirus type 18 variants: histopathology and E6/E7 polymorphisms in three countries. | journal = Int J Cancer | volume = 114 | issue = 3 | pages = 422-5 | month = Apr | year = 2005 | doi = 10.1002/ijc.20727 | PMID = 15551313 }}</ref>
| |
| **'''Eigh'''teen = '''a'''denocarcinoma.
| |
| *HPV 16 - predominantly squamous cell carcinoma.<ref name=pmid15551313/>
| |
| **'''S'''ixteen = '''s'''quamous.
| |
| *HPV 31.
| |
| *HPV 33.
| |
| *HPV 45.
| |
| | |
| ====Oncogenesis====
| |
| Quick & dirty explanation of pathogenesis:<ref name=pmid12445661>{{Cite journal | last1 = Münger | first1 = K. | last2 = Howley | first2 = PM. | title = Human papillomavirus immortalization and transformation functions. | journal = Virus Res | volume = 89 | issue = 2 | pages = 213-28 | month = Nov | year = 2002 | doi = | PMID = 12445661 }}</ref><ref name=Ref_PCPBoD8_169>{{Ref PCPBoD8|169}}</ref>
| |
| *Virus integrates into host genome.
| |
| **This is accompanied by loss of ''viral gene E2'' (which suppresses function of E6 & E7).
| |
| *''Viral gene E6'' dysregulates ''p53''.
| |
| *''Viral gene E7'' dysregulates ''RB''.
| |
| | |
| ====Vaccine====
| |
| Recombinant vaccine (Gardasil, Silgard) - covers:<ref name=pmid21942919>{{Cite journal | last1 = McCormack | first1 = PL. | last2 = Joura | first2 = EA. | title = Spotlight on Quadrivalent Human Papillomavirus(Types 6, 11, 16, 18) Recombinant Vaccine(Gardasil®) in the Prevention of PremalignantGenital Lesions, Genital Cancer, and Genital Warts in Women†. | journal = BioDrugs | volume = 25 | issue = 5 | pages = 339-43 | month = Oct | year = 2011 | doi = 10.2165/11205060-000000000-00000 | PMID = 21942919 }}</ref>
| |
| *HPV 6.
| |
| *HPV 11.
| |
| *HPV 16.
| |
| *HPV 18.
| |
| | |
| ===Microscopic===
| |
| Features:
| |
| *Koilocytes:
| |
| ** Perinuclear clearing.
| |
| ** Nuclear changes.
| |
| *** Size similar (or larger) to those in the basal layer of the epithelium.
| |
| *** Nuclear enlargement should be evident on low power, i.e. 25x.
| |
| *** Central location - nucleus should be smack in the middle of the cell.
| |
| | |
| Images:
| |
| *[http://commons.wikimedia.org/w/index.php?title=File:Low-grade_squamous_intraepithelial_lesion.jpg LSIL (WC)].
| |
| *[http://commons.wikimedia.org/wiki/File:Low-grade_sil_and_endocx.jpg LSIL & endocervix (WC)].
| |
| | |
| ===IHC===
| |
| *p16 +ve -- stains most cells infected by HPV.
| |
|
| |
|
| ==Adenovirus== | | ==Adenovirus== |