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Vyas N.S.,University of South Florida | Pierce Campbell C.M.,H. Lee Moffitt Cancer Center and Research Institute | Mathew R.,University of South Florida | Abrahamsen M.,H. Lee Moffitt Cancer Center and Research Institute | And 15 more authors.
Journal of Medical Virology | Year: 2015

Early HPV infection in males is difficult to detect clinically and pathologically. This study assessed histopathology in diagnosing male genital HPV. External genital lesions (n=352) were biopsied, diagnosed by a dermatopathologist, and HPV genotyped. A subset (n=167) was diagnosed independently by a second dermatopathologist and also re-evaluated in detail, tabulating the presence of a set of histopathologic characteristics related to HPV infection. Cases that received discrepant diagnoses or HPV-related diagnoses were evaluated by a third dermatopathologist (n=163). Across dermatopathologists, three-way concordance was fair (k=0.30). Pairwise concordance for condyloma was fair to good (k=0.30-0.67) and poor to moderate for penile intraepithelial neoplasia (k=-0.05 to 0.42). Diagnoses were 44-47% sensitive and 65-72% specific for HPV 6/11-containing lesions, and 20-37% sensitive and 98-99% specific for HPV 16/18. Presence of HPV 6/11 was 75-79% sensitive and 35% specific for predicting pathologic diagnosis of condyloma. For diagnosis of penile intraepithelial neoplasia, HPV 16/18 was 95-96% specific but only 40-64% sensitive. Rounded papillomatosis, hypergranulosis, and dilated vessels were significantly (P<0.05) associated with HPV 6/11. Dysplasia was significantly (P=0.001) associated with HPV 16/18. Dermatopathologists' diagnoses of early male genital HPV-related lesions appear discordant with low sensitivity, while genotyping may overestimate clinically significant HPV-related disease. Rounded papillomatosis, hypergranulosis, and dilated vessels may help establish diagnosis of early condyloma. © 2015 Wiley Periodicals, Inc.

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