- Diagnostic criteria for differentiated vulvar intraepithelial neoplasia and vulvar aberrant maturation
- Heller, Debra S.; Day, Tania; Allbritton, Jill I.; Scurry, James; Radici, Gianluigi; Welch, Kathryn; Preti, Mario
- Journal of Lower Genital Tract Disease Vol. 25, Issue 1, p. 57-70
- Publisher Link
- Lippincott Williams & Wilkins
- Resource Type
- journal article
- Objective: The aim of the study was to describe the features required for diagnosis of differentiated vulvar intraepithelial neoplasia (dVIN) and vulvar aberrant maturation (VAM). Materials and Methods: The International Society of the Study of Vulvovaginal Diseases tasked the difficult pathologic diagnoses committee to develop consensus recommendations for clinicopathologic diagnosis of vulvar lichen planus, lichen sclerosus, and dVIN. The dVIN subgroup reviewed the literature and formulated diagnostic criteria that were reviewed by the committee and then approved by the International Society of the Study of Vulvovaginal Diseases membership. Results: Differentiated vulvar intraepithelial neoplasia is the immediate precursor of human papillomavirus (HPV)–independent vulvar squamous cell carcinoma and shows a spectrum of clinical and microscopic appearances, some overlapping with HPV-related neoplasia. The histopathologic definition of dVIN is basal atypia combined with negative or nonblock-positive p16 and basal overexpressed, aberrant negative, or wild-type p53. The most common pattern of dVIN is keratinizing with acanthosis, aberrant rete ridge pattern, and premature maturation. The morphologic spectrum of keratinizing dVIN includes hypertrophic, atrophic, acantholytic, and subtle forms. A few dVIN cases are nonkeratinizing, with basaloid cells replacing more than 60% of epithelium. Vulvar aberrant maturation is an umbrella term for lesions with aberrant maturation that arise out of lichenoid dermatitis and lack the basal atypia required for dVIN. Conclusions: Evaluation of women at risk for dVIN and VAM requires a collaborative approach by clinicians and pathologists experienced in vulvar disorders. Close surveillance of women with lichen sclerosus and use of these recommendations may assist in prevention of HPV-independent squamous cell carcinoma through detection and treatment of dVIN and VAM.
- vulva; differentiated VIN; SDG 3; vulvar aberrant maturation; HPV-independent; squamous cell carcinoma; lichen sclerosus; lichen planus; high grade squamous intraepithelial lesion; Sustainable Development Goals; SDG 7
- Copyright © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the ASCCP. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
- Full Text
- Hits: 3158
- Visitors: 3556
- Downloads: 426
|View Details Download||ATTACHMENT02||Publisher version (open access)||1 MB||Adobe Acrobat PDF||View Details Download|