1. Vaginal Neoplasia Induced by an Unusual Papillomavirus Subtype in a Woman with Inherited Chromosomally Integrated Human Herpesvirus Type 6A.
- Author
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Pichon M, Gaymard A, Lebail-Carval K, Frobert E, Beaufils E, Chene G, Tommasino M, Lina B, Gaucherand P, Gautheret-Dejean A, Bonnafous P, Gheit T, Buenerd A, Lamblin G, and Mekki Y
- Subjects
- Antibodies, Viral blood, Colposcopy, DNA, Viral analysis, Female, Gammapapillomavirus, Humans, Middle Aged, Papillomaviridae genetics, Papillomavirus Infections diagnosis, Papillomavirus Infections genetics, Papillomavirus Infections virology, Roseolovirus Infections immunology, Squamous Intraepithelial Lesions of the Cervix pathology, Squamous Intraepithelial Lesions of the Cervix virology, Uterine Cervical Neoplasms pathology, Vagina pathology, Vaginal Neoplasms pathology, Vaginal Neoplasms surgery, Virus Integration genetics, Uterine Cervical Dysplasia pathology, Uterine Cervical Dysplasia virology, Herpesvirus 6, Human immunology, Roseolovirus Infections complications, Vaginal Neoplasms virology
- Abstract
We describe here a case of high-grade vaginal squamous lesion in a 54-year-old woman with a papillomaviruses (HPV) genital infection that developed from a cervical low-grade squamous intraepithelial lesion (SIL) to a high-grade SIL (H-SIL) on cytological examination. A colposcopy exam led to the detection of suspect vaginal lesions with granulomatous infiltrations, which were classified as a Vaginal Intra-Epithelial Neoplasia grade 2 after pathologists' analyses. After a laser vaginal surgery and a loop excision of the transformation zone, the analyses of the anatomical pieces using a near-complete HPV screening panel revealed an HPV-4 infection that was not detected before in cervical smears. This HPV-infection is associated with a high human herpesvirus type 6A (HHV-6A) viral load in the same anatomical piece. The presence of an inherited chromosomally integrated HHV-6A (iciHHV-6A) was proved in this patient by real-time polymerase chain reaction on hair follicles and nail. This case suggests reconsidering both the benign nature of low-grade lesions in the female genital tract and the well-known "good" prognosis of low-risk HPV infection, especially when iciHHV-6A is diagnosed. This clinical course insists on the benefits of the multiplex panel use or global sequencing in order to optimize biological testing sensitivity, and so enhance clinical management of infection-induced neoplasia., (© 2017 S. Karger AG, Basel.)
- Published
- 2017
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