Anus and Perianus: Condyloma Acuminatum

Definition

Human papilloma virus associated superficial papillary lesion of anal and perianal zone

Superficial lesion of squamous mucosa
- No invasion
Acanthosis with papillomatosis
- Variable hyperkeratosis
- Superficial parakeratosis usually present
- May have focal accentuation of the granular layer
Superficial koilocytosis
- Perinuclear clearing
- Hyperchromatic “raisinoid” nuclei
  - Irregular nuclear membrane
  - May be binucleate
Orderly maturation
- Mitotic figures basal unless inflamed
- Dyskeratosis may be present
Dysplasia usually low grade (LSIL/AIN1)
- Occasional cases with high grade dysplasia (HSIL/AINII or III)
- Occasional cases with invasive squamous carcinoma
- Thorough sampling required to exclude these findings

Teri A Longacre MD
Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342