Penile intraepithelial neoplasia: Difference between revisions
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| Image = Penile intraepithelial neoplasia -- intermed mag.jpg | | Image = Penile intraepithelial neoplasia -- intermed mag.jpg | ||
| Width = | | Width = | ||
| Caption = Penile intraepithelial neoplasia. [[H&E stain]]. | | Caption = Penile intraepithelial neoplasia (undifferentiated subtype). [[H&E stain]]. | ||
| Synonyms = | | Synonyms = | ||
| Micro = | | Micro = | ||
| Subtypes = differentiated PeIN, | | Subtypes = differentiated PeIN, undifferentiated PeIN | ||
| LMDDx = [[squamous cell carcinoma of the penis]], [[squamous hyperplasia]] | | LMDDx = [[squamous cell carcinoma of the penis]], [[squamous hyperplasia]] | ||
| Stains = | | Stains = | ||
| IHC = p16 +ve ( | | IHC = p16 +ve (uPeIN) -ve (dPeIN), p53 -ve (uPeIN) +ve (dPeIN) | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = | ||
| Line 16: | Line 16: | ||
| Grossing = | | Grossing = | ||
| Site = [[penectomy grossing]] | | Site = [[penectomy grossing]] | ||
| Assdx = [[HPV]] infection ( | | Assdx = [[HPV]] infection (undifferentiated PeIN), [[lichen sclerosus]] or [[BXO]] (differentiated PeIN) | ||
| Syndromes = | | Syndromes = | ||
| Clinicalhx = | | Clinicalhx = | ||
| Line 39: | Line 39: | ||
==Microscopic== | ==Microscopic== | ||
Subclassified | Subclassified as:<ref name=pmid22641959>{{Cite journal | last1 = Velazquez | first1 = EF. | last2 = Chaux | first2 = A. | last3 = Cubilla | first3 = AL. | title = Histologic classification of penile intraepithelial neoplasia. | journal = Semin Diagn Pathol | volume = 29 | issue = 2 | pages = 96-102 | month = May | year = 2012 | doi = | PMID = 22641959 }}</ref> | ||
* | *Undifferentiated PeIN (uPeIN). | ||
*Differentiated PeIN (dPeIN). | *Differentiated PeIN (dPeIN). | ||
=== | Note: | ||
*Subclassification similar to one for [[vulvar intraepithelial neoplasia]], that is based on the role of [[HPV]] in the pathogenesis. | |||
===Undifferentiated penile intraepithelial neoplasia=== | |||
Features: | Features: | ||
*Increased [[NC ratio]]. | *Increased [[NC ratio]]. | ||
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===Images=== | ===Images=== | ||
<gallery> | <gallery> | ||
Image: Penile intraepithelial neoplasia -- low mag.jpg | | Image: Penile intraepithelial neoplasia -- low mag.jpg | uPeIN - low mag. (WC) | ||
Image: Penile intraepithelial neoplasia - alt -- low mag.jpg | | Image: Penile intraepithelial neoplasia - alt -- low mag.jpg | uPeIN - low mag. (WC) | ||
Image: Penile intraepithelial neoplasia -- intermed mag.jpg | | Image: Penile intraepithelial neoplasia -- intermed mag.jpg | uPeIN - intermed. mag. (WC) | ||
Image: Penile intraepithelial neoplasia - alt -- intermed mag.jpg | | Image: Penile intraepithelial neoplasia - alt -- intermed mag.jpg | uPeIN - intermed. mag. (WC) | ||
Image: Penile intraepithelial neoplasia -- high mag.jpg | | Image: Penile intraepithelial neoplasia -- high mag.jpg | uPeIN - high mag. (WC) | ||
Image: Penile intraepithelial neoplasia - alt -- high mag.jpg | | Image: Penile intraepithelial neoplasia - alt -- high mag.jpg | uPeIN - high mag. (WC) | ||
Image: Adjacent parakeratosis and reactive changes -- intermed mag.jpg | Parakeratosis & reactive changes - intermed. mag. (WC) | Image: Adjacent parakeratosis and reactive changes -- intermed mag.jpg | Parakeratosis & reactive changes - intermed. mag. (WC) | ||
</gallery> | </gallery> | ||
==IHC== | ==IHC== | ||
*p16 -ve in dPeIN,<ref>{{Cite journal | last1 = Oertell | first1 = J. | last2 = Caballero | first2 = C. | last3 = Iglesias | first3 = M. | last4 = Chaux | first4 = A. | last5 = Amat | first5 = L. | last6 = Ayala | first6 = E. | last7 = Rodríguez | first7 = I. | last8 = Velázquez | first8 = EF. | last9 = Barreto | first9 = JE. | title = Differentiated precursor lesions and low-grade variants of squamous cell carcinomas are frequent findings in foreskins of patients from a region of high penile cancer incidence. | journal = Histopathology | volume = 58 | issue = 6 | pages = 925-33 | month = May | year = 2011 | doi = 10.1111/j.1365-2559.2011.03816.x | PMID = 21585428 }}</ref> +ve in | *p16 -ve in dPeIN,<ref>{{Cite journal | last1 = Oertell | first1 = J. | last2 = Caballero | first2 = C. | last3 = Iglesias | first3 = M. | last4 = Chaux | first4 = A. | last5 = Amat | first5 = L. | last6 = Ayala | first6 = E. | last7 = Rodríguez | first7 = I. | last8 = Velázquez | first8 = EF. | last9 = Barreto | first9 = JE. | title = Differentiated precursor lesions and low-grade variants of squamous cell carcinomas are frequent findings in foreskins of patients from a region of high penile cancer incidence. | journal = Histopathology | volume = 58 | issue = 6 | pages = 925-33 | month = May | year = 2011 | doi = 10.1111/j.1365-2559.2011.03816.x | PMID = 21585428 }}</ref> +ve in uPeIN. | ||
==Sign out== | |||
<pre> | |||
Skin, Penile Lesion, Excision: | |||
- High-grade penile intraepithelial neoplasia (PeIN), undifferentiated type. | |||
-- Margin POSITIVE for PeIN. | |||
</pre> | |||
==See also== | ==See also== | ||