Article: 

Differentiated Vulvar Intraepithelial Neoplasia Associated with Intraepithelial Neoplastic Spread

Kien T. Mai, MD (1), Bojana Djordjevic, MD (2)

(1) Department of Pathology and Laboratory Medicine, University of Ottawa, Ontario, Canada

(2) Division of Anatomic Pathology, Sunnybrook Health Sciences Centre, Department of Pathobiology and Laboratory Medicine, University of Toronto, Toronto Ontario, Canada

Running Title: Vulvar Intraepithelial Neoplasia

 

Address for correspondence:

Dr. K.T. Mai

Department of Pathology and Laboratory Medicine,

University of Ottawa, Ontario, Canada

451 Smyth Road,. Ottawa, ON K1H 8M5.

Tel: (613) 8213399, Fax: (613) 8215415

E-mail address: trungkienmai@hotmail.com

 

Conflict statement: The authors have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

 

Abstract

Aims: Differentiated vulvar intraepithelial neoplasia (dVIN) associated with intraepithelial neoplastic spread and with usual vulvar intraepithelial neoplasia (uVIN) has not been studied.

Materials and Methods: Consecutive cases of vulvar intraepithelial neoplasia (VIN) diagnosed between 2011-2013 were reviewed. The neoplastic epithelia with or without accompanied invasive squamous cell carcinoma were categorized into: dVIN, uVIN and dVIN associated with scattered atypical neoplastic spread above the parabasal layer in the usual-like VIN pattern (u-like VIN). The lesions were examined with p16 immunostaining.
Results: Two- hundred-thirty-five consecutive cases of VIN including 54 invasive squamous cell carcinoma were identified. There were 12 dVIN (invasive, n=8, or 67%), 178 uVIN (invasive, n=5 or 3%) and 45 u-like VIN with or without uVIN (invasive, n=41 or 91%). u-like VIN surface keratinisation exhibited features of keratinizing dysplasia. P16 was immunoreactive in 8%, 69% and 40% of dVIN, uVIN and u-like VIN lesions, respectively.

Conclusions: Like dVIN, u-like VIN is commonly associated with invasive squamous cell carcinoma. Therefore, its distinction from uVIN is of pathological and clinical significance.

Keywords: Vulvar, Intraepithelial, Neoplasia, Differentiated

 

 

 

 

 

 

 

 

 

 

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