What is Koilocytosis?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 12 August 2019
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Koilocytosis is a form of cellular change that can be observed in the epithelial cells that line the cervix with some types of medical conditions. While it is not itself malignant, it can be a warning sign of malignancy or another medical problem. If a smear test reveals koilocytosis upon laboratory examination, additional follow-up tests may be recommended to learn more about the source of the change and the patient may be advised to get rigorous screenings in the future in order to identify any malignant changes as early as possible. Patients with a history of abnormal smear tests who are changing doctors should make sure that their history is noted.

In koilocytosis, the nuclei of the cells become enlarged, growing two to three times larger than they should. The nuclei may also be very dark and stain readily, a trait known as hyperchromasia. In addition, the contours of the nuclei appear to be surrounded by halos or rings. Perinuclear halos, as they are known, are a signature calling card of koilocytosis. These cellular changes are visible upon staining and magnification in a lab setting.


The most common reason for this change to occur is infection with the human papilloma virus (HPV). HPV can cause cellular changes in infected women, including changes that develop into malignancies. Koilocytosis is also present in cancerous and precancerous cells. Because it can be associated with cancer, when koilocytosis is identified, additional medical screening is needed to learn more about why the cells are changing.

A procedure known as a colposcopy can be used to take a larger biopsy sample while examining the area in question under very clear, bright illumination. This procedure offers care providers an opportunity to identify cellular changes and take samples from specific areas for follow-up. The biopsy sample will be tested in a lab for abnormalities and a report will be generated with more information for the clinician.

Some patients may have HPV for life and not experience any additional medical problems, even if abnormal cells do develop. Other patients may develop cervical cancer. Regular screening allows a doctor to identify the signs of malignancies as early as possible so that appropriate treatments and interventions can be provided. Patients who have an abnormal smear test result should not panic. There are many factors that can cause abnormal results and the usual recommended response is more testing to confirm that there are abnormalities and to learn more about the cellular changes that are occurring.


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Post 3

@MissDaphne: That is not true. I have koilocytes and do *not* have HPV. I know this because I have had an HPV-specific test. Even above it says "most commonly" with HPV but that "Koilocytosis is also present in cancerous and precancerous cells".

@rugbygirl: Your friend's daughter should look further into it and see if she can discover the source of her koilocytosis if she is certain it's not HPV. They can run a specific HPV test to see if that is the cause.

Post 2

@rugbygirl - I'm pretty sure that koilocytes are only found when there's HPV. Your friend's daughter, unfortunately, has genital warts and is at high risk for cervical cancer.

But tell your friend there's no reason to panic. A dear friend of mine has this virus; I don't think she's ever had an abnormal Pap, but she's had the virus since she was a teen and is now in her mid-thirties with three lovely, healthy kids. But this girl should be screened as often as every six months so that if, God forbid, she were to develop cervical cancer, it would be caught at an early, treatable stage. No point taking chances with her health.

Post 1

Are there any causes of koilocytosis besides HPV? My friend's college- age daughter has had an abnormal Pap test but is denying to her mother that she has an STD. My friend won't be mad at her daughter (except maybe for the lying), she just wants to know what's going on so she can best help her.

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