Differentiated vulvar intraepithelial neoplasia: Difference between revisions

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| Caption    = Differentiated vulvar intraepithelial neoplasia. [[H&E stain]].
| Caption    = Differentiated vulvar intraepithelial neoplasia. [[H&E stain]].
| Synonyms  =
| Synonyms  = VIN simplex, simplex-type VIN
| Micro      = thickening of the stratum spinosum ([[acanthosis]]), elongation of rete ridges with bridging/anastomoses between rete ridges, nuclear atypia - esp. basal layer, nuclei in stratum corneum (parakeratosis), +/-atypical mitoses
| Micro      = thickening of the stratum spinosum ([[acanthosis]]), elongation of rete ridges with bridging/anastomoses between rete ridges, nuclear atypia - esp. basal layer, nuclei in stratum corneum (parakeratosis), +/-atypical mitoses
| Subtypes  =
| Subtypes  =
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'''Differentiated vulvar intraepithelial neoplasia''', abbreviated '''dVIN''', is a pre-neoplastic pathology of the [[vulva]] typically arising in the context of [[lichen sclerosus]].
'''Differentiated vulvar intraepithelial neoplasia''', abbreviated '''dVIN''', is a pre-neoplastic pathology of the [[vulva]] typically arising in the context of [[lichen sclerosus]].


It is also known as '''VIN simplex'''.<ref name=pmid15910611>{{Cite journal  | last1 = Ruhul Quddus | first1 = M. | last2 = Xu | first2 = C. | last3 = Steinhoff | first3 = MM. | last4 = Zhang | first4 = C. | last5 = Lawrence | first5 = WD. | last6 = Sung | first6 = CJ. | title = Simplex (differentiated) type VIN: absence of p16INK4 supports its weak association with HPV and its probable precursor role in non-HPV related vulvar squamous cancers. | journal = Histopathology | volume = 46 | issue = 6 | pages = 718-20 | month = Jun | year = 2005 | doi = 10.1111/j.1365-2559.2005.02036.x | PMID = 15910611 }}</ref>
It is also known as '''VIN simplex''',<ref name=pmid15910611>{{Cite journal  | last1 = Ruhul Quddus | first1 = M. | last2 = Xu | first2 = C. | last3 = Steinhoff | first3 = MM. | last4 = Zhang | first4 = C. | last5 = Lawrence | first5 = WD. | last6 = Sung | first6 = CJ. | title = Simplex (differentiated) type VIN: absence of p16INK4 supports its weak association with HPV and its probable precursor role in non-HPV related vulvar squamous cancers. | journal = Histopathology | volume = 46 | issue = 6 | pages = 718-20 | month = Jun | year = 2005 | doi = 10.1111/j.1365-2559.2005.02036.x | PMID = 15910611 }}</ref> and '''simplex-type VIN'''.<ref name=pmid24399036/>
 
==General==
==General==
Epidemiology:
Epidemiology:
*Associated with [[lichen sclerosus]].
*Associated with [[lichen sclerosus]].
*Seen in older women - typically 50s-70s.<ref name=pmid19730361>{{Cite journal  | last1 = Ordi | first1 = J. | last2 = Alejo | first2 = M. | last3 = Fusté | first3 = V. | last4 = Lloveras | first4 = B. | last5 = Del Pino | first5 = M. | last6 = Alonso | first6 = I. | last7 = Torné | first7 = A. | title = HPV-negative vulvar intraepithelial neoplasia (VIN) with basaloid histologic pattern: an unrecognized variant of simplex (differentiated) VIN. | journal = Am J Surg Pathol | volume = 33 | issue = 11 | pages = 1659-65 | month = Nov | year = 2009 | doi = 10.1097/PAS.0b013e3181b40081 | PMID = 19730361 }}</ref>
*Seen in older women - typically 50s-70s.<ref name=pmid19730361>{{Cite journal  | last1 = Ordi | first1 = J. | last2 = Alejo | first2 = M. | last3 = Fusté | first3 = V. | last4 = Lloveras | first4 = B. | last5 = Del Pino | first5 = M. | last6 = Alonso | first6 = I. | last7 = Torné | first7 = A. | title = HPV-negative vulvar intraepithelial neoplasia (VIN) with basaloid histologic pattern: an unrecognized variant of simplex (differentiated) VIN. | journal = Am J Surg Pathol | volume = 33 | issue = 11 | pages = 1659-65 | month = Nov | year = 2009 | doi = 10.1097/PAS.0b013e3181b40081 | PMID = 19730361 }}</ref>
*More common than ''[[classic VIN]]'' caused by HPV;<ref name=pmid21946295>{{Cite journal  | last1 = Kokka | first1 = F. | last2 = Singh | first2 = N. | last3 = Faruqi | first3 = A. | last4 = Gibbon | first4 = K. | last5 = Rosenthal | first5 = AN. | title = Is differentiated vulval intraepithelial neoplasia the precursor lesion of human papillomavirus-negative vulval squamous cell carcinoma? | journal = Int J Gynecol Cancer | volume = 21 | issue = 7 | pages = 1297-305 | month = Oct | year = 2011 | doi = 10.1097/IGC.0b013e31822dbe26 | PMID = 21946295 }}</ref> dVIN ~60% vs. classic VIN ~40%.<ref name=pmid24399036>{{Cite journal  | last1 = Reyes | first1 = MC. | last2 = Cooper | first2 = K. | title = An update on vulvar intraepithelial neoplasia: terminology and a practical approach to diagnosis. | journal = J Clin Pathol | volume =  | issue =  | pages =  | month = Jan | year = 2014 | doi = 10.1136/jclinpath-2013-202117 | PMID = 24399036 }}</ref>
*More common than ''[[classic VIN]]'' caused by HPV.<ref name=pmid21946295>{{Cite journal  | last1 = Kokka | first1 = F. | last2 = Singh | first2 = N. | last3 = Faruqi | first3 = A. | last4 = Gibbon | first4 = K. | last5 = Rosenthal | first5 = AN. | title = Is differentiated vulval intraepithelial neoplasia the precursor lesion of human papillomavirus-negative vulval squamous cell carcinoma? | journal = Int J Gynecol Cancer | volume = 21 | issue = 7 | pages = 1297-305 | month = Oct | year = 2011 | doi = 10.1097/IGC.0b013e31822dbe26 | PMID = 21946295 }}</ref>
**Differentiated VIN -> keratinizing SCC (~60% of cases).<ref name=pmid24399036/>
**Classic VIN -> warty SCC (~40% of cases).<ref name=pmid24399036>{{Cite journal  | last1 = Reyes | first1 = MC. | last2 = Cooper | first2 = K. | title = An update on vulvar intraepithelial neoplasia: terminology and a practical approach to diagnosis. | journal = J Clin Pathol | volume =  | issue =  | pages =  | month = Jan | year = 2014 | doi = 10.1136/jclinpath-2013-202117 | PMID = 24399036 }}</ref>


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