If you diagnose condyloma purely depend upon finding classic viral cytopathic effect (classic koilocytes), you are underdiagnose this entity. Dr. Chris Crum wrote this nice review in 2005 stating that although the majority of condylomas are having classic viral cytopathic effect, there are some condylomas are without viral cytopathic effect (such as the so called fibroepithelial polyp) and some look like seborrheic keratosis.

The reference is below:

 Medeiros F, and Crum CP. Advance Anatomic Pathology, 2005: 12:20-26.

 No convincing koilocytes. 

A newer but not very new concept in lower GYN tract pathology: seborrheic keratosis and skin tags in vulva and vicinity are often caused by low risk HPV infection even if you don't see morphologic evidence of HPV effects (no koilocytes).  The low rish HPV infection can be confirmed by IHC, FISH or PCR (in research, usually not used in clinical practice.  I had to use FISH to prove it in one case as requested by the patient).

学习了

 不是典型的尖锐湿疣。

个人体会：兼有HPV证据和典型形态才诊断尖锐湿疣。仅有HPV证据无典型形态报湿疣性病变，无HPV证据仅有典型形态报湿疣样病变。

除了没见到挖空细胞，别的都符合，仔细找一下挖空细胞，应该是