Vulva, vulvar intraepithelial neoplasia [LMP68087]

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Diagnostic Modality: 
Whole Slide Image
Disease Category: 
Neoplasia
Diagnosis: 
Vulvar intraepithelial neoplasia, differentiated‐type with basaloid features
Species: 
Human
Organ System: 
Female Genital Tract
Gender: 
Female
Age: 
87 Years
Diagnosis Code: 
ICD‐10: N90.2 | ICD‐O: 8071/2
Slide Contributor Information
Parra-Herran, C., Chang, M.

Keywords

Vulvar intraepithelial neoplasia, HSIL, high grade squamous intraepithelial lesion

Clinical History

History of lichen sclerosus and squamous cell carcinoma (well differentiated) of the vulva. Now, presents with a new vulvar plaque.

Clinical Discussion

Early (non‐invasive) vulvar cancer, or vulvar intraepithelial neoplasia (VIN) can be HPV‐associated or differentiated type. Although basaloid morphology is usually associated with HPV, this case is an example of a VIN lesion arising in an older patient without evidence of HPV infection (see attached image showing negative p16 immunohistochemical stain.) The diagnosis is based on the degree of atypia seen in the basal layer. The p53 and MIB‐1 stains highlight the cells of interest in this case, but are not necessary for routine diagnosis.

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