Vulva - Revision history

Michael: /* Condyloma acuminatum */ split out

2016-03-08T15:43:55Z

Condyloma acuminatum: split out

← Older revision		Revision as of 15:43, 8 March 2016
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	==Condyloma acuminatum==		==Condyloma acuminatum==
	*[[AKA]] ''genital [[wart]]''.		*[[AKA]] ''genital [[wart]]''.
	~~===General===~~		{{Main\|Condyloma acuminatum}}
	*Due to [[human papillomavirus]] (HPV).
	**Transmission: sexual, non-sexual, horizontal (mother to child).<ref name=Ref_APBR280>{{~~Ref APBR~~\|~~280 Q29}}</ref>~~
	***Should raise the suspicion of child abuse.

	~~Note:~~
	*Related to [[verruca vulgaris]] (common wart).
	*The Bethesda system includes this in [[LSIL]].<ref>{{Ref GP\|143}}</ref>

	~~Clinical DDx:~~
	*[[Molluscum contagiosum]].<ref>URL: [http://emedicine.medscape.com/article/781735-differential http://emedicine.medscape.com/article/781735-differential]. Accessed on: 5 July 2013.</ref>

	~~===Microscopic===~~
	~~Features:~~
	*Koilocytes.<ref name=pmid11860848>{{Cite journal \| last1 = Huang \| first1 = Z. \| last2 = Yang \| first2 = S. \| last3 = Li \| first3 = Q. \| last4 = Yan \| first4 = P. \| last5 = Li \| first5 = L. \| title = [Evaluation the pathological diagnostic values of koilocyte in condyloma acuminatum~~]. \| journal = Zhonghua Liu Xing Bing Xue Za Zhi \| volume = 22 \| issue = 1 \| pages = 58-60 \| month = Feb \| year = 2001 \| doi = \| PMID = 11860848 }}</ref>~~
	**Cells with an enlarged nucleus and perinuclear clearing.
	*Papillomatosis.<ref>{{Ref WMSP\|204}}</ref>
	**Papillomatosis = surface elevation due to dermal papillae enlargement.<ref>{{Ref PBoD\|1230}}~~</ref>~~
	*+/-Parakeratosis.

	~~DDx:~~
	*[[Classic vulvar intraepithelial neoplasia]] - architecture different.

	~~====Images====~~
	~~<gallery>~~
	~~Image:Condyloma_acuminatum_-_low_mag.jpg \| Condyloma acuminatum - low mag. (WC)~~
	~~Image:Condyloma_acuminatum_-_very_high_mag.jpg \| Condyloma acuminatum - very high mag. (WC)~~
	~~Image:Anal_condyloma_%282%29.jpg \| Condyloma acuminatum - 2. (WC)~~
	~~Image:Anal_condyloma_%284%29.jpg \| Condyloma acuminatum - 3. (WC)~~
	~~</gallery>~~

	~~===Sign out===~~
	~~<pre>~~
	~~SKIN LESION ("VULVAR WART"), VULVA, EXCISION:~~
	~~- CONDYLOMA ACUMINATUM (GENITAL WART).~~
	~~</pre>~~

	~~<pre>~~
	~~LABIA MINORA, BIOPSY:~~
	~~- CONDYLOMA/LOW-GRADE SQUAMOUS INTRAEPITHELIAL LESION (LSIL).~~
	~~-- NEGATIVE FOR HIGH-GRADE DYSPLASIA.~~
	~~</pre>~~
	~~====Seborrheic keratosis-like====~~
	~~<pre>~~
	~~Submitted as "Penile Wart", Excision:~~
	~~- Consistent with condyloma acuminatum (genital wart) with~~
	~~seborrheic keratosis-like features.~~
	~~</pre>~~

	~~=====Block letters=====~~
	~~<pre>~~
	~~SKIN LESION, PERINEUM, BIOPSY:~~
	~~- SEBORRHEIC KERATOSIS-LIKE CONDYLOMA ACUMINATUM (GENITAL WART).~~
	~~</pre>~~

	~~====Without viral cytopathic changes====~~
	~~<pre>~~
	~~VULVAR LESIONS (x3), EXCISION:~~
	~~- SQUAMOUS HYPERPLASIA WITH HYPERORTHOKERATOSIS WITHOUT VIRAL CYTOPATHIC EFFECT,~~
	~~COMPATIBLE WITH CONDYLOMA (x3).~~
	~~- NEGATIVE FOR MALIGNANCY.~~
	~~</pre>~~

	~~====Micro====~~
	The sections show a polypoid fragment of skin with epithelium on three sides, acanthosis, hyperkeratosis and parakeratosis. Koilocytic changes (mild nuclear enlargement, perinuclear clearing) are seen focally. There is mild basilar nuclear enlargement and hyperchromasia. The epithelium shows maturation to the surface and a granular layer is present.

	~~=====Seborrheic keratosis-like=====~~
	The sections show skin with acanthosis with papillomatous features (round bulbous rete ridges, acanthosis with penetrating fibrovascular cores) pseudohorn cysts, parakeratosis and hyperkeratosis. There is no significant basal nuclear atypia. There are no mitoses and no melanocytic nests. There is mild dermal inflammation. There is no solar elastosis. Pigment incontinence is present focally.

	==Lichen sclerosus==		==Lichen sclerosus==

Michael: /* Seborrheic keratosis-like */

2016-03-08T15:41:14Z

Seborrheic keratosis-like

← Older revision		Revision as of 15:41, 8 March 2016
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	</pre>		</pre>
	====Seborrheic keratosis-like====		====Seborrheic keratosis-like====
			<pre>
			Submitted as "Penile Wart", Excision:
			- Consistent with condyloma acuminatum (genital wart) with
			seborrheic keratosis-like features.
			</pre>

			=====Block letters=====
	<pre>		<pre>
	SKIN LESION, PERINEUM, BIOPSY:		SKIN LESION, PERINEUM, BIOPSY:

Michael: /* Bartholin cyst */

2015-09-01T14:47:03Z

Bartholin cyst

← Older revision		Revision as of 14:47, 1 September 2015
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	===Sign out===		===Sign out===
	====Compatible with Bartholin cyst====		====Compatible with Bartholin cyst====
			<pre>
			Submitted as "Bartholin's cyst wall - left", Excision:
			- Connective tissue with overlying urothelium that is focally
			denuded and associated with a lymphohistiocytic response,
			compatible with Bartholin's cyst.
			- NEGATIVE for dysplasia and NEGATIVE for malignancy.
			</pre>

			=====Block letters=====
	<pre>		<pre>
	VAGINA, CYST WALL, BIOPSY:		VAGINA, CYST WALL, BIOPSY:

Michael: /* Micro */

2014-05-16T15:58:40Z

Micro

← Older revision		Revision as of 15:58, 16 May 2014
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	=====Micro=====		=====Micro=====
	The sections show a small piece of squamous mucosa with mild hypergranulosis and a compact keratin layer. The epithelial component is not significantly thickened but contains rare intraepithelial lymphocytes and has minimal edema. ~~The epithelium has no atypia. No mitotic figures are readily apparent.~~ The subepithelial tissue has rare scattered lymphocytes and a mild prominence of small blood vessels. No subepithelial fibrosis is appreciated.		The sections show a small piece of squamous mucosa with mild hypergranulosis and a compact keratin layer. The epithelial component is not significantly thickened but contains rare intraepithelial lymphocytes and has minimal edema. The subepithelial tissue has rare scattered lymphocytes and a mild prominence of small blood vessels. No subepithelial fibrosis is appreciated. The epithelium has no atypia. No mitotic figures are readily apparent.

	=Benign disease=		=Benign disease=

Michael: /* Normal vulva */

2014-05-16T15:58:06Z

Normal vulva

← Older revision		Revision as of 15:58, 16 May 2014
Line 39:		Line 39:
	=====Micro=====		=====Micro=====
	The sections show squamous mucosa with a mild chronic inflammatory infiltrate that consists predominantly of lymphocytes. There is mild nuclear enlargement and intracellular edema. The nuclear membranes are regular. No nuclear hyperchromasia is apparent. No mitotic activity is readily apparent.		The sections show squamous mucosa with a mild chronic inflammatory infiltrate that consists predominantly of lymphocytes. There is mild nuclear enlargement and intracellular edema. The nuclear membranes are regular. No nuclear hyperchromasia is apparent. No mitotic activity is readily apparent.

			====Hyperkeratotic====
			<pre>
			VULVA, BIOPSY:
			- SQUAMOUS MUCOSA WITH MILD HYPERGRANULOSIS AND A THIN COMPACT LAYER OF KERATIN.
			- NO SIGNIFICANT INFLAMMATION.
			- NEGATIVE FOR DYSPLASIA.
			</pre>

			=====Micro=====
			The sections show a small piece of squamous mucosa with mild hypergranulosis and a compact keratin layer. The epithelial component is not significantly thickened but contains rare intraepithelial lymphocytes and has minimal edema. The epithelium has no atypia. No mitotic figures are readily apparent. The subepithelial tissue has rare scattered lymphocytes and a mild prominence of small blood vessels. No subepithelial fibrosis is appreciated.

	=Benign disease=		=Benign disease=

Michael: /* Condyloma acuminatum */

2014-04-10T18:43:20Z

Condyloma acuminatum

← Older revision		Revision as of 18:43, 10 April 2014
Line 102:		Line 102:

	====Micro====		====Micro====
	The sections show a polypoid fragment of skin with epithelium on three sides, acanthosis, hyperkeratosis and parakeratosis. Koilocytic changes (mild nuclear enlargement, perinuclear clearing) are seen focally. There is mild basilar nuclear enlargement and hyperchromasia. The epithelium ~~matures~~ to the surface and a granular layer is present.		The sections show a polypoid fragment of skin with epithelium on three sides, acanthosis, hyperkeratosis and parakeratosis. Koilocytic changes (mild nuclear enlargement, perinuclear clearing) are seen focally. There is mild basilar nuclear enlargement and hyperchromasia. The epithelium shows maturation to the surface and a granular layer is present.

	=====Seborrheic keratosis-like=====		=====Seborrheic keratosis-like=====

Michael: /* Classic vulvar intraepithelial neoplasia */ split-out

2014-02-25T01:51:16Z

Classic vulvar intraepithelial neoplasia: split-out

← Older revision		Revision as of 01:51, 25 February 2014
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	*Abbreviated ''classic VIN'' or ''cVIN''.		*Abbreviated ''classic VIN'' or ''cVIN''.
	*[[AKA]] ''usual VIN'' or ''uVIN''.<ref name=pmid24399036>{{Cite journal \| last1 = Reyes \| first1 = MC. \| last2 = Cooper \| first2 = K. \| title = An update on vulvar intraepithelial neoplasia: terminology and a practical approach to diagnosis. \| journal = J Clin Pathol \| volume = \| issue = \| pages = \| month = Jan \| year = 2014 \| doi = 10.1136/jclinpath-2013-202117 \| PMID = 24399036 }}</ref>		*[[AKA]] ''usual VIN'' or ''uVIN''.<ref name=pmid24399036>{{Cite journal \| last1 = Reyes \| first1 = MC. \| last2 = Cooper \| first2 = K. \| title = An update on vulvar intraepithelial neoplasia: terminology and a practical approach to diagnosis. \| journal = J Clin Pathol \| volume = \| issue = \| pages = \| month = Jan \| year = 2014 \| doi = 10.1136/jclinpath-2013-202117 \| PMID = 24399036 }}</ref>
	~~===General===~~		{{Main\|Classic vulvar intraepithelial neoplasia}}
	~~Epidemiology:~~
	*Classic VIN, like CIN, is associated with [[HPV]] and seen in younger women.
	*May be multifocal, i.e. associated with cervical ([[CIN]]) or vaginal ([[VAIN]]) lesions;<ref>{{~~Cite journal \| last1 = Pai \| first1 = K. \| last2 = Pai \| first2 = S. \| last3 = Gupta \| first3 = A. \| last4 = Rao \| first4 = P. \| last5 = Renjhen~~ \| first5 = P. \| title = Synchronous vulvar intraepithelial neoplasia (VIN) of warty type and cervical intraepithelial neoplasia (CIN): case report. \| journal = Indian J Pathol Microbiol \| volume = 49 \| issue = 4 \| pages = 585-7 \| month = Oct \| year = 2006 \| doi = \| PMID = 17183865 }}</ref> multifocality has a strongly association with immunosuppression.<ref name=pmid16713062>{{Cite journal \| last1 = Ait Menguellet \| first1 = S. \| last2 = Collinet \| first2 = P. \| last3 = Houfflin Debarge \| first3 = V. \| last4 = Nayama \| first4 = M. \| last5 = Vinatier \| first5 = D. \| last6 = Leroy \| first6 = JL. \| title = Management of multicentric lesions of the lower genital tract. \| journal = Eur J Obstet Gynecol Reprod Biol \| volume = 132 \| issue = 1 \| pages = 116-20 \| month = May \| year = 2007 \| doi = 10.1016/j.ejogrb.2006.04.011 \| PMID = 16713062 }}</ref>

	Classic ~~VIN is graded like cervical pre-cancerous lesions:~~
	*VIN I.
	**DDx: [[condyloma acuminatum]].<ref name=pmid15870532>{{Cite journal \| last1 = Rufforny \| first1 = I. \| last2 = Wilkinson \| first2 = EJ. \| last3 = Liu \| first3 = C. \| last4 = Zhu \| first4 = H. \| last5 = Buteral \| first5 = M. \| last6 = Massoll \| first6 = NA. \| title = Human papillomavirus infection and p16(INK4a) protein expression in vulvar intraepithelial neoplasia ~~and invasive squamous cell carcinoma. \| journal = J Low Genit Tract Dis \| volume = 9 \| issue = 2 \| pages = 108-13 \| month = Apr \| year = 2005 \| doi = \| PMID = 15870532 }}</ref>~~
	**Uncommon.
	*VIN II.
	**Not common.
	*VIN III.
	**Commonly seen.

	~~===Microscopic===~~
	~~Features:~~
	*Increased [[NC ratio]].
	*Multinucleation.
	*Lack of maturation to surface (not very useful -- unlike in the cervix).<ref>LAE. February 2009.</ref>
	**May have "vertical streaming" - the long axis of the cells are perpendicular to the free surface & basement membrane.
	*Apical mitoses.

	~~DDx:~~
	*[[Condyloma acuminatum]].
	*[[Vulvar squamous cell carcinoma]].
	*[[Extramammary Paget disease]].
	*[[Dermatomycosis]] (fungal infection) - esp. [[candidiasis]].

	~~Images:~~
	*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150314/figure/F3/ VIN I - koilocytes (nih.gov)].<ref name=pmid21702970/>
	*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150314/figure/F4/ VIN I (nih.gov)].<ref name=pmid21702970>{{Cite journal \| last1 = Kotsopoulos \| first1 = IC. \| last2 = Tampakoudis \| first2 = GP. \| last3 = Evaggelinos \| first3 = DG. \| last4 = Nikolaidou \| first4 = AI. \| last5 = Fytili \| first5 = PA. \| last6 = Kartsiounis \| first6 = VC. \| last7 = Gerasimidou \| first7 = DK. \| title = Implication of human papillomavirus-66 in vulvar carcinoma: a case report. \| journal = J Med Case Rep \| volume = 5 \| issue = \| pages = 232 \| month = \| year = 2011 \| doi = 10.1186/1752-1947-5-232 \| PMID = 21702970 \| PMC = 3150314 }}</ref>
	*[http://www.flickr.com/photos/euthman/2658773592/ VIN III (flickr.com)].
	*[http://commons.wikimedia.org/wiki/File:Vulvar_intraepithelial_neoplasia3_2.jpg VIN III (WC)].
	*[http://www.brown.edu/Courses/Digital_Path/systemic_path/female/warty_VIN.html VIN (brown.edu)].

	~~===IHC===~~
	*Classic VIN: p16 +ve, p53 -ve.
	*Differentiated VIN: p16 -ve, p53 +ve.<ref name=pmid20062014>{{Cite journal \| last1 = Pinto \| first1 = AP. \| last2 = Miron \| first2 = A. \| last3 = Yassin \| first3 = Y. \| last4 = Monte \| first4 = N. \| last5 = Woo \| first5 = TY. \| last6 = Mehra \| first6 = KK. \| last7 = Medeiros \| first7 = F. \| last8 = Crum \| first8 = CP. \| title = Differentiated vulvar intraepithelial neoplasia contains Tp53 mutations and is genetically linked to vulvar squamous cell carcinoma. \| journal = Mod Pathol \| volume = 23 \| issue = 3 \| pages = 404-12 \| month = Mar \| year = 2010 \| doi = 10.1038/modpathol.2009.179 \| PMID = 20062014 }}~~</ref>~~

	~~Note:~~
	*p16 can be thought of as a poor man's HPV test.

	~~===Sign out===~~
	~~====VIN I====~~
	~~<pre>~~
	~~VULVA, BIOPSY:~~
	~~- CLASSIC VULVAR INTRAEPITHELIAL NEOPLASIA (VIN) I (MILD DYSPLASIA).~~
	~~- NEGATIVE FOR INVASIVE MALIGNANCY.~~
	~~</pre>~~

	~~====VIN III====~~
	~~<pre>~~
	~~VULVA, EXCISION:~~
	~~- CLASSIC VULVAR INTRAEPITHELIAL NEOPLASIA (VIN) III (SEVERE DYSPLASIA)~~
	~~WITH FOCAL ULCERATION.~~
	~~- MARGIN FOCALLY POSITIVE FOR VIN III.~~
	~~- NEGATIVE FOR INVASIVE MALIGNANCY.~~
	~~</pre>~~

	==Differentiated vulvar intraepithelial neoplasia==		==Differentiated vulvar intraepithelial neoplasia==

Michael: /* Classic vulvar intraepithelial neoplasia */

2014-02-25T01:45:59Z

Classic vulvar intraepithelial neoplasia

← Older revision		Revision as of 01:45, 25 February 2014
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	==Classic vulvar intraepithelial neoplasia==		==Classic vulvar intraepithelial neoplasia==
	*Abbreviated ''classic VIN'' or ''cVIN''.		*Abbreviated ''classic VIN'' or ''cVIN''.
			*[[AKA]] ''usual VIN'' or ''uVIN''.<ref name=pmid24399036>{{Cite journal \| last1 = Reyes \| first1 = MC. \| last2 = Cooper \| first2 = K. \| title = An update on vulvar intraepithelial neoplasia: terminology and a practical approach to diagnosis. \| journal = J Clin Pathol \| volume = \| issue = \| pages = \| month = Jan \| year = 2014 \| doi = 10.1136/jclinpath-2013-202117 \| PMID = 24399036 }}</ref>
	===General===		===General===
	Epidemiology:		Epidemiology:

Michael: /* Differentiated vulvar intraepithelial neoplasia */ split out

2014-02-24T18:21:30Z

Differentiated vulvar intraepithelial neoplasia: split out

← Older revision		Revision as of 18:21, 24 February 2014
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	*Abbreviated ''dVIN''.		*Abbreviated ''dVIN''.
	*[[AKA]] ''VIN simplex''.<ref name=pmid15910611>{{Cite journal \| last1 = Ruhul Quddus \| first1 = M. \| last2 = Xu \| first2 = C. \| last3 = Steinhoff \| first3 = MM. \| last4 = Zhang \| first4 = C. \| last5 = Lawrence \| first5 = WD. \| last6 = Sung \| first6 = CJ. \| title = Simplex (differentiated) type VIN: absence of p16INK4 supports its weak association with HPV and its probable precursor role in non-HPV related vulvar squamous cancers. \| journal = Histopathology \| volume = 46 \| issue = 6 \| pages = 718-20 \| month = Jun \| year = 2005 \| doi = 10.1111/j.1365-2559.2005.02036.x \| PMID = 15910611 }}</ref>		*[[AKA]] ''VIN simplex''.<ref name=pmid15910611>{{Cite journal \| last1 = Ruhul Quddus \| first1 = M. \| last2 = Xu \| first2 = C. \| last3 = Steinhoff \| first3 = MM. \| last4 = Zhang \| first4 = C. \| last5 = Lawrence \| first5 = WD. \| last6 = Sung \| first6 = CJ. \| title = Simplex (differentiated) type VIN: absence of p16INK4 supports its weak association with HPV and its probable precursor role in non-HPV related vulvar squamous cancers. \| journal = Histopathology \| volume = 46 \| issue = 6 \| pages = 718-20 \| month = Jun \| year = 2005 \| doi = 10.1111/j.1365-2559.2005.02036.x \| PMID = 15910611 }}</ref>
			{{Main\|Differentiated vulvar intraepithelial neoplasia}}
	~~===General===~~
	~~Epidemiology:~~
	*Associated with [[lichen sclerosus]].
	*Seen in older women.

	~~Note:~~
	*'''Not''' associated with [[HPV]].<ref name=pmid10716158>{{~~Cite journal~~ \| last1 = Yang \| first1 = B. \| last2 = Hart \| first2 = WR. \| title = Vulvar intraepithelial neoplasia of the simplex (differentiated) type: a clinicopathologic study including analysis of HPV and p53 expression. \| journal = Am J Surg Pathol \| volume = 24 \| issue = 3 \| pages = 429-41 \| month = Mar \| year = 2000 \| doi = \| PMID = 10716158 }}</ref>

	~~===Microscopic===~~
	Features:<ref name=pmid21057461>{{Cite journal \| last1 = van de Nieuwenhof \| first1 = HP. \| last2 = Bulten \| first2 = J. \| last3 = Hollema \| first3 = H. \| last4 = Dommerholt \| first4 = RG. \| last5 = Massuger \| first5 = LF. \| last6 = van der Zee \| first6 = AG. \| last7 = de Hullu \| first7 = JA. \| last8 = van Kempen \| first8 = LC. \| title = Differentiated vulvar intraepithelial neoplasia is often found in lesions, previously diagnosed as lichen sclerosus, which have progressed to vulvar squamous cell carcinoma. \| journal = Mod Pathol \| volume = 24 \| issue = 2 \| pages = 297-305 \| month = Feb \| year = 2011 \| doi = 10.1038/modpathol.2010.192 \| PMID = 21057461 }}~~</ref>~~
	*Thickening of the stratum spinosum ([[acanthosis]]).
	*Elongation of rete ridges with bridging/anastomoses between rete ridges.
	*Nuclear atypia - esp. basal layer.
	*Nuclei in stratum corneum (parakeratosis).
	*+/-Atypical mitoses.

	~~Notes:~~
	*'''Not''' graded like classic VIN.
	*Mnemonic ''BAD LAP'': '''b'''asal cell atypia, '''a'''nastomosing rete ridges (bridging), '''d'''VIN, '''l'''ichen sclerosus, '''a'''canthosis, '''p'''arakeratosis.

	~~DDx:~~
	*[[Lichen sclerosus]].
	*[[Lichen simplex chronicus]] (squamous hyperplasia).

	~~====Images====~~
	~~<gallery>~~
	~~Image:Differentiated_vulvar_intraepithelial_neoplasia_-_low_mag.jpg \| Differentiated VIN - low mag. (WC)~~
	~~Image:Differentiated_vulvar_intraepithelial_neoplasia_-_intermed_mag.jpg \| Differentiated VIN - intermed. mag. (WC)~~
	~~Image:Differentiated_vulvar_intraepithelial_neoplasia_-_deep_-_high_mag.jpg \| Differentiated VIN - deep - high mag. (WC)~~
	~~</gallery>~~
	~~www:~~
	*[http://www.nature.com/modpathol/journal/v24/n2/fig_tab/modpathol2010192f3.html#figure-title Differentiated VIN (nature.com)].<ref name=pmid21057461>{{Cite journal \| last1 = van de Nieuwenhof \| first1 = HP. \| last2 = Bulten \| first2 = J. \| last3 = Hollema \| first3 = H. \| last4 = Dommerholt \| first4 = RG. \| last5 = Massuger \| first5 = LF. \| last6 = van der Zee \| first6 = AG. \| last7 = de Hullu \| first7 = JA. \| last8 = van Kempen \| first8 = LC. \| title = Differentiated vulvar intraepithelial neoplasia is often found in lesions, previously diagnosed as lichen sclerosus, which have progressed to vulvar squamous cell carcinoma. \| journal = Mod Pathol \| volume = 24 \| issue = 2 \| pages = 297-305 \| month = Feb \| year = 2011 \| doi = 10.1038/modpathol.2010.192 \| PMID = 21057461 }}</ref>
	*[http://www.nature.com/modpathol/journal/v23/n3/fig_tab/modpathol2009179f1.html Differentiated VIN with bridging rete ridges (nature.com)].<ref name=pmid20062014>{{Cite journal \| last1 = Pinto \| first1 = AP. \| last2 = Miron \| first2 = A. \| last3 = Yassin \| first3 = Y. \| last4 = Monte \| first4 = N. \| last5 = Woo \| first5 = TY. \| last6 = Mehra \| first6 = KK. \| last7 = Medeiros \| first7 = F. \| last8 = Crum \| first8 = CP. \| title = Differentiated vulvar intraepithelial neoplasia contains Tp53 mutations and is genetically linked to vulvar squamous cell carcinoma. \| journal = Mod Pathol \| volume = 23 \| issue = 3 \| pages = 404-12 \| month = Mar \| year = 2010 \| doi = 10.1038/modpathol.2009.179 \| PMID = 20062014 }}</ref>
	~~===IHC===~~
	*Differentiated VIN: p16 -ve, p53 +ve.<ref name=pmid20062014/>
	*Classic VIN: p16 +ve, p53 -ve.

	~~Note:~~
	*p16 can be thought of as a poor man's [[HPV]] test.

	=Malignant neoplasms of the vulva=		=Malignant neoplasms of the vulva=

Michael: /* Hidradenoma papilliferum */ split out

2014-02-17T04:28:10Z

Hidradenoma papilliferum: split out

← Older revision		Revision as of 04:28, 17 February 2014
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	==Hidradenoma papilliferum==		==Hidradenoma papilliferum==
	*[[AKA]] ''papillary hidradenoma''.<ref>Hidradenoma papilliferum. Stedman's Medical Dictionary. 27th Ed.</ref>		*[[AKA]] ''papillary hidradenoma''.<ref>Hidradenoma papilliferum. Stedman's Medical Dictionary. 27th Ed.</ref>
	~~===General===~~		{{Main\|papillary hidradenoma}}
	*Dermal thingy; hidradenoma = tumour of sweat duct epithelium.<ref>URL: [http://medical-dictionary.thefreedictionary.com/hidradenoma http://medical-dictionary.thefreedictionary.com/hidradenoma]. Accessed on: 14 April 2011.</ref>
	*Looks like ''[[intraductal papilloma]] of the breast''.<ref>{{Ref PBoD\|1067}}</ref>
	*Uncommon.<ref name=pmid21132312>{{Cite journal \| last1 = Duhan \| first1 = N. \| last2 = Kalra \| first2 = R. \| last3 = Singh \| first3 = S. \| last4 = Rajotia \| first4 = N. \| title = Hidradenoma papilliferum of the vulva: case report and review of literature. \| journal = Arch Gynecol Obstet \| volume = 284 \| issue = 4 \| pages = 1015-7 \| month = Oct \| year = 2011 \| doi = 10.1007/s00404-010-1784-7 \| PMID = 21132312 }}</ref>

	~~===Gross===~~
	*Nodule.

	~~Note:~~
	*Classically vulvar - reported in various locations.
	**Perianal.<ref name=pmid21132312/><ref name=pmid17347625>{{~~Cite journal~~ \| ~~last1 = Daniel \| first1 = F. \| last2 = Mahmoudi \| first2 = A. \| last3 = de Parades \| first3 = V. \| last4 = Fléjou \| first4 = JF. \| last5 = Atienza \| first5 = P. \| title = An uncommon perianal nodule:~~ hidradenoma ~~papilliferum. \| journal = Gastroenterol Clin Biol \| volume = 31 \| issue = 2 \| pages = 166-8 \| month = Feb \| year = 2007 \| doi = \| PMID = 17347625~~ }}~~</ref>~~
	**Abdomen.<ref>{{Cite journal \| last1 = Morimura \| first1 = S. \| last2 = Kadono \| first2 = T. \| last3 = Sugaya \| first3 = M. \| last4 = Sato \| first4 = S. \| title = Ectopic hidradenoma papilliferum on the abdomen. \| journal = Eur J Dermatol \| volume = 21 \| issue = 2 \| pages = 278-9 \| month = \| year = \| doi = 10.1684/ejd.2010.1236 \| PMID = 21411413 }}</ref>

	~~===Microscopic===~~
	~~Features:~~
	*Cystic spaces.
	*Epithelium with apocrine differentiation (as demonstrated by apocrine snouts).
	*Well-circumscribed.

	~~Images:~~
	*[[WC]]:
	**[http://commons.wikimedia.org/wiki/File:Papillary_hidradenoma_-_low_mag.jpg Papillary hidradenoma - low mag. (WC)].
	**[http://commons.wikimedia.org/wiki/File:Papillary_hidradenoma_-_very_high_mag.jpg Papillary hidradenoma - very high mag. (WC)].
	*www:
	**[http://farm4.static.flickr.com/3019/2646470314_12fb77d3ec_z.jpg Hidradenoma papilliferum (flickr.com)].

	~~Notes:~~
	*No attachment to epidermis.
	*No nuclear changes suggestive of malignancy.

	~~===Sign out===~~
	~~<pre>~~
	~~VULVAR LESION, EXCISION:~~
	~~- PAPILLARY HIDRADENOMA.~~
	~~</pre>~~

	=Vulvar neoplasia=		=Vulvar neoplasia=