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Difference between revisions of "Classic vulvar intraepithelial neoplasia"
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Classic vulvar intraepithelial neoplasia (view source)
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Vulvar_intraepithelial_neoplasia3_1.jpg | |||
| Width = | |||
| Caption = Classic vulvar intraepithelial neoplasia. [[H&E stain]]. | |||
| Synonyms = usual vulvar intraepithelial neoplasia | |||
| Micro = increased [[NC ratio]], multinucleation, lack of maturation to surface (not very useful -- unlike in the cervix), +/-non-basal mitoses, +/-atypical mitoses | |||
| Subtypes = | |||
| LMDDx = [[vulvar squamous cell carcinoma]], [[condyloma acuminatum]], [[dermatomycosis]] | |||
| Stains = | |||
| IHC = p16 +ve, p53 -ve, Ki-67 - suprabasal staining | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[vulva]] | |||
| Assdx = [[vulvar squamous cell carcinoma]], other [[HPV]] lesions | |||
| Syndromes = | |||
| Clinicalhx = young women | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = uncommon | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = | |||
| Other = | |||
| ClinDDx = | |||
| Tx = | |||
}} | |||
'''Classic vulvar intraepithelial neoplasia''', abbreviated '''classic VIN''', is a pre-neoplastic lesion of the [[vulva]] strongly associated with the [[human papilloma virus]]. | '''Classic vulvar intraepithelial neoplasia''', abbreviated '''classic VIN''', is a pre-neoplastic lesion of the [[vulva]] strongly associated with the [[human papilloma virus]]. | ||
| Line 27: | Line 58: | ||
DDx: | DDx: | ||
*[[Condyloma acuminatum]]. | *[[Condyloma acuminatum]]. | ||
*[[Vulvar squamous cell carcinoma]]. | *[[Vulvar squamous cell carcinoma]], esp. warty type. | ||
*[[Extramammary Paget disease]]. | *[[Extramammary Paget disease]]. | ||
*[[Dermatomycosis]] (fungal infection) - esp. [[candidiasis]]. | *[[Dermatomycosis]] (fungal infection) - esp. [[candidiasis]]. | ||
===Images=== | ===Images=== | ||
<gallery> | |||
Image:Vulvar_intraepithelial_neoplasia3_1.jpg | VIN III. (WC) | |||
Image:Vulvar_intraepithelial_neoplasia3_2.jpg | VIN III. (WC) | |||
</gallery> | |||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150314/figure/F3/ VIN I - koilocytes (nih.gov)].<ref name=pmid21702970/> | *[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150314/figure/F3/ VIN I - koilocytes (nih.gov)].<ref name=pmid21702970/> | ||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150314/figure/F4/ VIN I (nih.gov)].<ref name=pmid21702970>{{Cite journal | last1 = Kotsopoulos | first1 = IC. | last2 = Tampakoudis | first2 = GP. | last3 = Evaggelinos | first3 = DG. | last4 = Nikolaidou | first4 = AI. | last5 = Fytili | first5 = PA. | last6 = Kartsiounis | first6 = VC. | last7 = Gerasimidou | first7 = DK. | title = Implication of human papillomavirus-66 in vulvar carcinoma: a case report. | journal = J Med Case Rep | volume = 5 | issue = | pages = 232 | month = | year = 2011 | doi = 10.1186/1752-1947-5-232 | PMID = 21702970 | PMC = 3150314 }}</ref> | *[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150314/figure/F4/ VIN I (nih.gov)].<ref name=pmid21702970>{{Cite journal | last1 = Kotsopoulos | first1 = IC. | last2 = Tampakoudis | first2 = GP. | last3 = Evaggelinos | first3 = DG. | last4 = Nikolaidou | first4 = AI. | last5 = Fytili | first5 = PA. | last6 = Kartsiounis | first6 = VC. | last7 = Gerasimidou | first7 = DK. | title = Implication of human papillomavirus-66 in vulvar carcinoma: a case report. | journal = J Med Case Rep | volume = 5 | issue = | pages = 232 | month = | year = 2011 | doi = 10.1186/1752-1947-5-232 | PMID = 21702970 | PMC = 3150314 }}</ref> | ||
*[http://www.flickr.com/photos/euthman/2658773592/ VIN III (flickr.com)]. | *[http://www.flickr.com/photos/euthman/2658773592/ VIN III (flickr.com)]. | ||
*[http://www.brown.edu/Courses/Digital_Path/systemic_path/female/warty_VIN.html VIN (brown.edu)]. | *[http://www.brown.edu/Courses/Digital_Path/systemic_path/female/warty_VIN.html VIN (brown.edu)]. | ||
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- NEGATIVE FOR INVASIVE MALIGNANCY. | - NEGATIVE FOR INVASIVE MALIGNANCY. | ||
</pre> | </pre> | ||
====VIN II==== | |||
<pre> | |||
LEFT LABIUM MINUS, PUNCH BIOPSY: | |||
- CLASSIC VULVAR INTRAEPITHELIAL NEOPLASIA (cVIN) II (MODERATE DYSPLASIA). | |||
- LICHEN SCLEROSUS. | |||
COMMENT: | |||
Immunostains: | |||
POSITIVE: p16 (strong, diffuse - lower 2/3 of the epithelium). | |||
NEGATIVE: HMB-45, S-100, p53 (weak, patchy, superficial squamous cells). | |||
PROLIFERATION (Ki-67): increased, marks superficial squamous cells (compatible with | |||
high-grade lesion). | |||
</pre> | |||
=====Micro===== | |||
The sections show a punch biopsy of skin. Compact hyperkeratosis and hypergranulosis is | |||
present. The epidermis is edematous, has moderately atypical cells in the lower two thirds | |||
of the epithelium and mitotic activity. Several suprabasal mitoses are present. Apoptotic | |||
keratinocytes are present. Granular yellow pigment (hemosiderin?) is present in the | |||
epidermis. The epidermis is not significantly thickened. The lesional cells extend | |||
to the lateral edges of the tissue. | |||
====VIN III==== | ====VIN III==== | ||
| Line 64: | Line 120: | ||
==See also== | ==See also== | ||
*[[Vulva]]. | *[[Vulva]]. | ||
*[[Differentiated vulvar intraepithelial neoplasia]]. | |||
==References== | ==References== | ||