Review Question - QID 108964

A 33-year-old G0P0 female presents to her gynecologist for a new patient visit. She has not visited a gynecologist for several years due to her fear of doctors. She reports that she feels well and has no complaints. She has been monogamous with a male partner for the past five years and they use barrier protection consistently. Her past medical history is notable for pelvic inflammatory disease in her early 20’s and she has a 15 pack-year smoking history. A bimanual examination reveals no cervical motion tenderness or adnexal tenderness. A pap smear is performed and reveals koilocytes. She subsequently undergoes a cone biopsy which is shown in Figure A. The changes seen in Figure A are most consistent with which of the following?