Discussion & Conclusion Cervicovaginal Smear Findings in First Discovered Human Papilloma Virus Infected Women Hussam Abu-Farsakh1, Yomna Abu-Farsakh2, Altaf Ijamil, Msc1       1First Medical Lab, 2Faculty of Medicine, Jordan University; Amman, Jordan. Replace with logo Abstract Material & Methods Results Discussion & Conclusion Context: Human Papilloma Virus (HPV) infects the nuclei of squamous cells in female genitalia. Secondary changes occur in the cells depending on HPV genotype and their duration. Design: 158 cases of first discovered HPV infected women, diagnosed positive for HPV by Polymerase chain reaction (PCR) performed on cervical swabs, were reviewed. HPV PCR test was performed on these women due to one of the following reasons: 1) abnormal pap smear findings (138 cases); history of vulvar warts (8 cases); Husband with positive HPV testing (12 cases). Results: Of the 158 women. 19 (12%) had normal pap smear, 33 (21%) had ASC-US; 39 (24%) had HPV suggestive changes; 56 (35%) had HPV definite changes, 2 cases had mild dysplasia; 6 cases had moderate dysplasia, 2 cases had severe dysplasia, one case had AGUS. Conclusions: The most common findings in cervical swabs of women initially tested positive for HPV (diagnosed by PCR method) were HPV suggestive or definite changes (60%). ASC-US is a common initial pap reading for HPV infected patients (25%). 12% patients with positive HPV test had negative pap smear findings. The presentation of HPV in infected women in Jordan has similar changes in cervicovaginal smears in the west. 158 cases of first discovered HPV infected women, diagnosed positive for HPV by Polymerase chain reaction (PCR) performed on cervical swabs, were reviewed. HPV PCR test was performed on these women due to one of the following reasons: 1) abnormal pap smear findings (138 cases); history of vulvar warts (8 cases); Husband with positive HPV testing (12 cases). The most common findings in cervical swabs of women initially tested positive for HPV (diagnosed by PCR method) were HPV suggestive or definite changes (60%). ASC-US is a common initial pap reading for HPV infected patients (25%). 12% patients with positive HPV test had negative pap smear findings. HPV changes in male urethral are present in the whole anogenital area, the glans penis in most of the time. But also can be present in the shaft , urethra, scrotum or groins. 1,2,3. Clinical examination shows in all cases small tiny papilloma, that may pass unnoticed to inexperienced clinician. That may explain why in some studies , clinical examination was not contributatory.4-5 . Urine cytology study by Levine et al [4] helped to detect HPV infection in 64, 16 and 50 percent of the men whose female partners had CIN I/condyloma, CIN II and CIN III respectively, while Krebs and Schneider 4 detected HPV infection by histology in 66, 67 and 60 percent of male consorts of females with CIN I, CIN II and CIN III respectively The presentation of HPV in infected women in Jordan has similar changes in cervicovaginal smears in the west. Of the 158 women. 19 (12%) had normal pap smear, 33 (21%) had ASC-US; 39 (24%) had HPV suggestive changes; 56 (35%) had HPV definite changes, 2 cases had mild dysplasia; 6 cases had moderate dysplasia, 2 cases had severe dysplasia, one case had AGUS. Fig 1: A: oligodendroglioma Grade II; B: negative nestin immunostaining (note positive endothelial staining) Fig 5: A: anaplastic astrocytoma, Grade III; B: strong Immunostaining for Nestin Fig 2: A: Anaplastic Oligodendroglioma Grade III; B: negative immunostaining for Nestin (note postive internal control staining in endothelial cells) Background Background References Fig3: A: Pilocystic astrocytoma; B: negative-weak staining in the astrocytes, but strong staining in Rosenthal fibers and eosinophilic granular bodies Krebs HB and Schneider V. Human papillomavirus - Associated lesions of the penis: colposcopy, cytology and histology. Obstet Gynecol 1987; 70: 299 – 304 Boon ME, Schneider A, Hogewoning CJA, Kwast H, Bolhuis P, Kok LP. Penile studies and heterosexual partners: penioscopy, cytology, histology and immunocytochemistry. Cancer 1988; 61: 652 – 9 Krebs HB. Genital HPV infections in men. Clin Obstet Gynecol 1989; 32: 180 – 90 Krebs HB and Schneider V. Human papillomavirus - Associated lesions of the penis: colposcopy, cytology and histology. Obstet Gynecol 1987; 70: 299 - 304 Cecchini S, Cipparrone I, Confortini M, et al. Urethral cytology of cytobrush specimens: a new technique for detecting subclinical human Papilloma virus infection in men. Acta Cytol 1988; 32: 314-7 Levine RU, Crum CP, Herman E, Silvers D, Ferenczy A, Richart RM. Cervical papilloma virus infection and intraepithelial neoplasia: a study of male sexual partners. Obstet Gynecol 1984; 64: 16-20 Fig 6: A: Glioblastoma multiforme B-D: very strong staining for Nestin Fig 4: A: low grade astrocytoam; B: weak staining in astrocytes