2014 Volume 73 Issue 1 Pages 31-35
Recently, there has been an increase in the number of patients with cervical intraepithelial neoplasia grade 3 (CIN3), corresponding to human papillomavirus (HPV) infection. Long-term HPV infection before surgery impacts recurrence at the cervical margin and vaginal stump, because HPV infection persists postoperatively. However, host immunocompetence also plays a role. In particular, elderly women have an immunodepleted local vaginal environment since depuration declines with hormonal dysfunction. A 77-year-old woman underwent simple total hysterectomy for severe dysplasia. High-risk HPV type 51 was identified prior to surgery. Pathological findings of the uterine sample were consistent with CIS. Four months later, atypical squamous cells were detected in the vaginal stump and the cytological report was “atypical squamous cells, cannot exclude HSIL (ASC-H)”, although the margin had been clear at hysterectomy. HPV type 51 was also detected in the vaginal stump. Cytological abnormalities are likely to influence high-risk HPV with long-term exposure and broad involvement from the cervix to the vagina.
