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- Title
Differentiated vulvar intraepithelial neoplasia associated with intraepithelial neoplastic spread and with usual vulvar intraepithelial neoplasia: A retrospective study.
- Authors
Mai, Kien T.; Senterman, Mary; Bateman, Justin; Djordjevic, Bojana
- Abstract
Objective: The objective of this project was to study differentiated vulvar intraepithelial neoplasia (dVIN) and its association with usual vulvar intraepithelial neoplasia (uVIN). Methods: Consecutive cases of vulvar intraepithelial neoplasia (VIN) diagnosed at our institution between 2011-13 were reviewed. The overlying and adjacent epithelium was categorized into: a) dVIN, characterized by atypical cells with abundant eosinophilic cytoplasm and wide intercellular spaces creating a "cobblestone" appearance in the basal/parabasal layers, b) uVIN, and c) dVIN associated with atypical neoplastic spread above the parabasal layer in the uVIN-like pattern (u-like VIN). Results: Two-hundred and thirty-five consecutive cases of VIN, including 54 invasive squamous cell carcinomas (SCC), were identified. There were 12 dVIN (invasive: n=8, or 67% of cases) (group 1), 178 uVIN (invasive: n=5 or 3%) (Group 2), and 45 u-like VIN with or without associated uVIN (invasive: n=41 or 91%) (Group 3). Surface keratinisation in u-like VIN exhibited features of keratinised dysplasia. P16 was immunoreactive in the overlying epithelium and in the invasive squamous cell carcinoma in 8%, 69% and 40% of cases in Groups 1, 2, and 3 respectively. Conclusions: In summary, dVIN associated with intraepithelial neoplastic spread and with uVIN is common in invasive vulvar SCC. Since u-like VIN is commonly associated with invasive SCC, its distinction from uVIN is of pathological and clinical significance.
- Publication
Canadian Journal of Pathology, 2016, Vol 8, p32
- ISSN
1918-915X
- Publication type
Article