What is Koilocytosis?
Koilocytosis is a pathological condition in which there is a change at the cell level in the epithelial cells which line the cervix due to some medical condition. With Koilocytosis, there is significant enlargement of the nuclei of the cells and they can grow up to three times their original size. These nuclei may become very dark and are stained easily and hence can be easily visible on scans. This trait is also known as hyperchromasia. Additionally, these nuclei appear to be surrounded by halos. The presence of these halos virtually pinpoints the presence of Koilocytosis.
Koilocytosis may themselves not produce any significant symptom but is considered to be a precursor for cervical cancer in females and hence if a female has a diagnosis of Koilocytosis with abnormal Pap smear tests then that female needs aggressive monitoring and constant screenings to look for presence of any cervical cancer.
What are the Causes of Koilocytosis?
The most common cause of Koilocytosis is the HPV or the human papilloma virus. This virus is normally transmitted through unprotected sex and this virus can cause cellular changes in females to include changes which may lead to abnormal cell growth taking the shape of a tumor which may be benign to start with but may become malignant later on.
In majority of cases, Koilocytosis is present in cancerous and precancerous cells and thus because of its association with malignant tumor growths if an individual has presence of Koilocytosis then it becomes necessary for that individual to undergo aggressive cancer screenings on a routine basis to see if there is any development of a tumor, especially around the cervical area. If such a tumor is found then appropriate treatment strategies may be formulated for its treatment.
Normally once Koilocytosis is suspected, then a process called as colposcopy is conducted and biopsies of the affected cells are taken to rule in or rule out any malignancies.
How is Koilocytosis Diagnosed?
Koilocytosis will be suspected if a female has three or more abnormal Pap Smear tests. Once Koilocytosis is suspected, then additional studies in the form of MRI and CT scans of the abdominal area with attention to the cervix is done to look at the cell structure and see if there is any darkening of the nuclei. If there is darkening of the nuclei with clearly visible halos surrounding the nuclei then the diagnosis of Koilocytosis is more or less confirmed.
Additionally, a colonscopy may be also done to visualize the cervix to look for any abnormalities. A biopsy of the affected cells may also be taken to look for any signs of malignancies. These studies virtually confirm the diagnosis of Koilocytosis.
How is Koilocytosis Treated?
Since Koilocytosis is mainly caused due to HPV infection, hence treatment of the infection is the way to treat Koilocytosis. However, at present there is no clear cut treatment for an HPV infection, although about 30% of such infections go away on their own and do not require treatment since the immune system of the body is sufficient enough to fight off this infection.
Koilocytosis caused due to HPV virus is a cause of concern due to its relationship with cancerous growths and the need for much aggressive treatment. These treatments can be done both surgically as well as through medicinal approaches. The treatment is aimed at eliminating these abnormal tissues causing overgrowth of abnormal cells. If this is not done then the chances of the patient going on to develop cancer becomes much more.
When it comes to surgical approaches towards treatment of Koilocytosis and other related HPV infections which can cause cancer, the preferred procedure is called the cryosurgery in which the abnormal tissues are cut out or eliminated by freezing them by way of electric currents or laser beams. Once the freezing is done, liquid nitrogen is applied and the tissues are taken out.
Another type of surgical procedure done for removing abnormal tissues from the cervical area which are the cause for Koilocytosis is called as the Loop Electrosurgical Excision Procedure or the LEEP procedure. This procedure uses a thin wire loop which is attached to a generator which delivers small electric currents which is used to cut away and vaporize the affected tissues.
- National Cancer Institute (NCI) – Cervical Cancer Treatment (PDQ®) – Health Professional Version: https://www.cancer.gov/types/cervical/hp/cervical-treatment-pdq
- Journal of Obstetrics and Gynaecology Canada – Human Papillomavirus Infection: Epidemiology, Natural History, and Cervical Cytology: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1473002/