Vulva: Difference between revisions

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==Microscopic examination==
==Microscopic examination==
[[File:Histopathology of high-grade squamous intraepithelial lesion (HSIL) of vulva.jpg|thumb|Histopathology of high-grade squamous intraepithelial lesion (HSIL) of vulva (left) with full thickness dysplasia, compared to normal epithelium at right.]]
[[File:Histopathology of high-grade squamous intraepithelial lesion (HSIL) of vulva.jpg|thumb|Histopathology of high-grade squamous intraepithelial lesion (HSIL) of vulva (left) with full thickness dysplasia, compared to normal epithelium at right.]]
Mainly look for squamous vulvar intraepithelial lesions, previously classified as VIN 1-3:
Mainly look for squamous vulvar intraepithelial lesions:
{|class=wikitable
*'''Low-grade squamous intraepithelial lesion (LSIL)''':<ref name=Choschzick>{{cite web|url=https://www.pathologyoutlines.com/topic/vulvaVIN.html|title=Vulva, vagina & female urethra - Squamous carcinoma and precursor lesions - HPV associated SIL|author=Matthias Choschzick|website=PathologyOutlines}} Topic Completed: 6 January 2021. Minor changes: 11 June 2021</ref>
! Source !! Mild dysplasia !! Moderate dysplasia !! Severe dysplasia / carcinoma in situ !! HPV-negative lesion with atypical keratinocytes in the basal cell layer
:*Acanthosis, papillomatosis, and/or atypical koilocytosis in upper layers
|-
:*Usually mild atypia and mitoses, limited to the lower third of stratum spinosum and basale
| WHO 2003<ref name="pmid27765958">{{cite journal| author=Schnürch HG, Ackermann S, Alt CD, Barinoff J, Böing C, Dannecker C | display-authors=etal| title=Diagnosis, Therapy and Follow-up Care of Vulvar Cancer and its Precursors. Guideline of the DGGG and DKG (S2k-Level, AWMF Registry Number 015/059, November 2015. | journal=Geburtshilfe Frauenheilkd | year= 2016 | volume= 76 | issue= 10 | pages= 1035-1049 | pmid=27765958 | doi=10.1055/s-0042-103728 | pmc=5066425 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27765958  }} </ref> || Vulvar intraepithelial neoplasia (VIN) 1 || VIN 2 || VIN 3 || VIN 3
:*Binucleated epithelial cells
|-
*'''High-grade squamous intraepithelial lesion (HSIL)''':<ref name=Choschzick/>
| WHO 2014 and ISSVD 2015<ref name="pmid27765958"/> ||colspan=2| Low-grade squamous intraepithelial lesion (LSIL) || High-grade squamous intraepithelial lesion (HSIL) || Intraepithelial neoplasia, differentiated type
:*Enlarged atypical nuclei and mitoses involving middle and upper third of the epithelium.
|}
:*Also telling are atypical mitoses and/or extension in hair follicles and skin appendages.
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Revision as of 09:04, 8 September 2021

Author: Mikael Häggström [note 1]

Gross processing

Generally as per skin.

Microscopic examination

Histopathology of high-grade squamous intraepithelial lesion (HSIL) of vulva (left) with full thickness dysplasia, compared to normal epithelium at right.

Mainly look for squamous vulvar intraepithelial lesions:

  • Low-grade squamous intraepithelial lesion (LSIL):[1]
  • Acanthosis, papillomatosis, and/or atypical koilocytosis in upper layers
  • Usually mild atypia and mitoses, limited to the lower third of stratum spinosum and basale
  • Binucleated epithelial cells
  • High-grade squamous intraepithelial lesion (HSIL):[1]
  • Enlarged atypical nuclei and mitoses involving middle and upper third of the epithelium.
  • Also telling are atypical mitoses and/or extension in hair follicles and skin appendages.

Notes

  1. ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. ↑ 1.0 1.1 Matthias Choschzick. Vulva, vagina & female urethra - Squamous carcinoma and precursor lesions - HPV associated SIL. PathologyOutlines. Topic Completed: 6 January 2021. Minor changes: 11 June 2021

Image sources


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