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Unusual patterns of squamous epithelium of the uterine cervix: Cytologic and pathologic study of koilo-cytotic atypia. In: Cancer cytology and cytochemistry. IV. The cytology of early cancer



Unusual patterns of squamous epithelium of the uterine cervix: Cytologic and pathologic study of koilo-cytotic atypia. In: Cancer cytology and cytochemistry. IV. The cytology of early cancer



Ann New York Acad Sci 63(5): 1245-1261



The koilocytotic atypia is an alteration of the surface squamous epithelium of the cervix and, when uncomplicated, it cannot be called cancer by our present criteria. The recognition of this epithelial pattern by pathologists will undoubtedly clarify the origin of many an abnormal cell seen in smears. Koilocytotic atypia can be associated with in situ or invasive cancer of the uterine cervix. Therefore, recognition of this pattern, either in smears or in sections, should not preclude search for cancer. The role of koilocytotic atypia as a stepping stone in the genesis of cervix cancer is not clear and, at this point, we cannot exclude the possibility that some of these lesions may progress to cancer. The evidence accumulated so far, however, indicates that some of these lesions may regress. At any rate, it is unlikely that the koilo-cytic lesion is a part of the natural history of more than a fraction of cervix cancers. In our own experience with a small number of women who developed in situ carcinoma while under observation, no clear-cut cytologic abnormalities suggestive of koilocytotic atypia were observed prior to the appearance of cancer. We feel that a great many years of follow-up will be necessary before the nature and the behavior of koilocytotic atypias and related lesions of cervix epithelium will be determined accurately.

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