What is Vulvar Intraepithelial Neoplasia?

Vulvar intraepithelial neoplasia is a precancerous skin condition on the vulva. It happens when there are changes in the cells of the skin covering the vulva.

What is the Pathology of Vulvar Intraepithelial Neoplasia?

The pathology of vulvar intraepithelial neoplasia is:

-Etiology: The cause of vulvar intraepithelial neoplasia is not known exactly, but herpes simplex virus and human papilloma virus are linked with it.

-Genes involved: None.

-Pathogenesis: The sequence of events that lead to vulvar intraepithelial neoplasia involve viral DNA integration into the cells causing production of oncoproteins which affect normal cellular function, allowing neoplastic cells to evade apoptosis.

-Morphology: The morphology associated with vulvar intraepithelial neoplasia shows abnormal skin.

-Histology: The histology associated with vulvar intraepithelial neoplasia shows enlarged nuclei, hyperchromasia, and pleomorphic cells.

Vulvar Intraepithelial Neoplasia, Grade 3 (VIN 3). Ed Uthman. Not altered. CC BY 2.0
Vulvar Carcinoma. Micrograph of vulvar intraepithelial neoplasia III (VIN III). H&E stain. See also Image:Vulvar_intraepithelial_neoplasia3_2.jpg - low magnification micrograph of VIN III Nephron. Not altered. CC BY-SA 3.0
Histology and p16ink4a immunostaining patterns of high-grade dVIN and uVIN samples.(A) dVIN, showing characteristic elongation and anastomosis of rete ridges. The epithelium shows enlarged keratinoocytes with abundant eosinophilic cytoplasm. The inset displays prominent cytologic atypia localized to the lower 1/3 of the epithelium. (B) uVIN, warty subtype. A spiked surface epithelium with hyperkeratosis and hypergranulosis is visualized. The inset displays full-thickness cytologic atypia. (C) p16ink4a immunostaining is negative in dVIN. (D) Full-thickness p16ink4a immunopositivity is seen in high-grade uVIN. Abbreviations: dVIN, differentiated vulvar intraepithelial neoplasia; uVIN, usual-type vulvar intraepithelial neoplasia. No viral association found in a set of differentiated vulvar intraepithelial neoplasia cases by human papillomavirus and pan-viral microarray testing. Saglam O, Samayoa E, Somasekar S, Naccache S, Iwasaki A, Chiu CY - PloS one (2015). Not Altered. CC.

How does Vulvar Intraepithelial Neoplasia Present?

Patients with vulvar intraepithelial neoplasia are females, usually in their 40s. The symptoms, features, and clinical findings associated with vulvar intraepithelial neoplasia include tingling or burning in vulvar region, soreness, redness, and painful intercourse.

How is Vulvar Intraepithelial Neoplasia Diagnosed?

Vulvar intraepithelial neoplasia is diagnosed by physical exam, coloposcopy, and biopsy.

How is Vulvar Intraepithelial Neoplasia Treated?

Vulvar intraepithelial neoplasia is treated by excision of the affected area, laser ablation, or topical imiquimod treatment.

What is the Prognosis of Vulvar Intraepithelial Neoplasia?

The prognosis of vulvar intraepithelial neoplasia is good. Please note that if the condition is left untreated it may progress towards invasive carcinoma.