Herpes Vulvitis

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22/02/53 Vulvar Intraepithelial Neoplasia (VIN) An intraepithelial squamous neoplasm of the vulva. If multiple abnormal areas , then …….. multiple biopsies are required…….. to "map" all potential sites of vulvar pathology. Usually associated with high risk HPV infection, especially ill types 16 or 18. peak kincidence id ~ 20-35 yrs 1/5 were assocd with SCC May follow, or be associated with cervical or vaginal neoplasia. A known precursor of vulvar squamous cell CA ~ 3% of genital malignancies in women VIN: LESION COLOR (N=73) 1. VIN and associated HPV infection (usually HPV type 16). 2. The simplex (differentiated) type of VIN, not associated with HPV infection 3. Lichen sclerosus with associated squamous hyperplasia 4. Chronic granulomatous vulvar disease such as granuloma inguinale (rare in developed countries) Color Patients # % White 41 56.2 Red 13 17.8 Pigmented 12 16.4 Unavailable 7 9.6 Wilkinson EJ, World Health Organization, 2004 Wilkinson EJ 6
22/02/53 VIN: type of lesion (N=73) Presentation Patients # % Multifocal l 57 78.1 Unifocal 15 20.5 Confluent 1 1.4 VIN type SCC Type HPV Related Warty Condylomatous (Warty) Yes carcinoma Basaloid Basaloid carcinoma Yes Differentiated Keratinizing carcinoma No (Simplex type) Wilkinson EJ VIN 1 Mild dysplasia VIN 2 Moderate dysplasia VIN 3 Severe dysplasia (8077/2) VIN 3 Carcinoma in situ (8072/2) * ICD-O, International Classification of Disease for Oncology Wilkinson EJ et al. Histological Typing of Female Genital Tract Tumors, in World Health Organization International Histological Classification of Tumours third Ed., 2004 * VIN 1: abnormal epithelial cell involve lower 1/3 of the epithelium (maturation in the upper 2/3 of epithelium) VIN 2: abnormal epithelial cell involve lower 1/2 of the epithelium (maturation in the upper 1/2 of epithelium) VIN 3: abnormal epithelial cell involve most or all of the epithelium ( maturation present in the upper 1/3 of epithelium) Wilkinson EJ, World Health Organization, 2004 VIN I Key points: Proliferation of basal layer Koilocytotic atypia * Enlarged pleomorphic nuclei * vacuolated cytoplasm -Disordered maturation * loss of polarity -Nuclear atypia * pleomorphism * coarse chromatin * irregular nuclear membrane * atypical MF VIN II • More proliferation • cytologic atypia in basal/parabasal layers • involving lower 1/2 epithelium 7
Page 1 and 2: 22/02/53 Clitoral hood Perineum Ra
Page 3 and 4: 22/02/53 may express in 3 forms 1.
Page 5: 22/02/53 hyperkeratosis... thickene
Page 9 and 10: 22/02/53 Cases should be classifie
Page 11 and 12: 22/02/53 • Uncommon variant of SC
Page 13 and 14: 22/02/53 * 1 st described in 1888,
Page 15 and 16: 22/02/53 DDx of vulvar intraepithel
Page 17 and 18: 22/02/53 Vaginal intraepithelial ne
Page 19 and 20: 22/02/53 Postoperative Spindle Cell
Page 21: 22/02/53 Aggressive angiomyxoma •

Herpes Vulvitis

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