Gynecologic and Obstetric Pathology

Verruciform Lichen Simplex Chronicus

D efinition —A clinical and pathologic response to continued physical trauma comprised of markedly thickened skin with verruciform changes along with erythema and plaquelike scaling. Clinical Features Epidemiology Seen in all demographic groups; however, has been associated with vulvar cancer…

Differentiated Vulvar Intraepithelial Neoplasia

D efinition —Vulvar intraepithelial neoplasia (VIN) that likely is secondary to a series of host gene alterations that are discrete from those involved in classic VIN. Clinical Features Epidemiology Occurs in postmenopausal women but can be seen earlier. Associated with…

Polynucleated Atypia of the Vulva

D efinition —A reactive epithelial process seen in skin or vulva characterized by a cytoskeletal defect with accumulation of nuclei in individual cells (multinucleation). Clinical Features Epidemiology No particular demographic other than an association with nonspecific, chronic, irritative, or inflammatory…

Epidermodysplasia Verruciformis–Like Atypia

PITFALL D efinition —A variant of epithelial atypia associated with gamma papillomaviruses, classically associated with epidermodysplasia verruciformis (EDV) but now appreciated in immunosuppressed (including human immunodeficiency virus [HIV]–infected) patients and involves the vulva. Clinical Features A wide age range. Multiple…

Vulvar Intraepithelial Neoplasia with Columnar Differentiation

PITFALL D efinition —A rare variant of vulvar intraepithelial neoplasia (VIN) with lesional columnar (i.e., mucinous) cells. Clinical Features Epidemiology Rare, affects a small fraction of the patients with classic VIN. You’re Reading a Preview Become a Clinical Tree membership…

Pagetoid Vulvar Intraepithelial Neoplasia

PITFALL D efinition —An unusual variant of vulvar intraepithelial neoplasia (VIN) in which the more poorly differentiated cells invade the overlying mature squamous epithelium. Clinical Features Epidemiology Rare, affects a small fraction of the patients with classic VIN. You’re Reading…

Classic Vulvar Intraepithelial Neoplasia (Bowenoid Dysplasia)

D efinition —Classic or “usual-type” vulvar intraepithelial neoplasia (VIN) with full-thickness atypia similar to that seen in bowenoid papulosis but with milder atypia. Clinical Features Epidemiology Consists of a fraction of the patients with classic VIN. May be seen in…

Classic Vulvar Intraepithelial Neoplasia with Lichen Simplex Chronicus

PITFALL D efinition —Human papillomavirus (HPV)-associated squamous intraepithelial lesion (SIL) with superimposed changes of lichen simplex chronicus (LSC). Clinical Features Epidemiology Affects a fraction of the patients with classic vulvar intraepithelial neoplasia (VIN). You’re Reading a Preview Become a Clinical…

Classic (Usual) Vulvar Intraepithelial Neoplasia

D efinition —Classic (usual) high-grade squamous intraepithelial lesions of the vulva are defined as full-thickness or near full-thickness atypias associated with high-risk or carcinogenic human papillomavirus (HPV) infections, principally HPV 16. Clinical Features A wide age range, from second to…

Flat Condyloma (VIN1)

D efinition —Flat condyloma is defined as a macular variant of condyloma that falls within the category of low-grade squamous intraepithelial lesion (LSIL) and displays an identical distribution of atypia as its exophytic counterpart. In contrast to exophytic condylomas, these…