43F Vulval sore area. Last biopsy in 2002 showed no evidence of VIN or invasive malignancy.
The vulval biopsy from the sore area shows prominent koilocytosis and multinucleation of squamous epithelial cells.
The epithelial cells show crowding and maturation abnormalities confined to the lower third of the epithelium , amounting to VIN1. These changes does not extend to the underlying structures .
The underlying mucosa shows a mild chronic inflammatory infiltrate.There is no ulceration ,erosion or any form of vulval dermatosis.
No invasive malignancy is seen.
38F H/O Pruritis and thickened pale skin of the labia minora.
Vulval epithelium shows cellular abnormalities which extends upto the middle third of the epithelium. There is cellular crowding. Atypical mitotic figures are present. The cells show nuclear enlargement and hyperchromasia. The lesion does not extend to the underlying appendages . No invasive malignancy is present.
A 51 year female with a history of genital HPV for last 2 years. Violaceous area on the vulva.
The vulval epithelium shows acanthosis. The rete ridges are widened. There is epithelial multinucleation, individual cell keratinization and koilocytosis. Cellular abnormalities are present throughout the full thickness of the squamous epithelium (amounting to VIN3) No evidence of invasive. malignancy.
A 28 year old female with a velvety lesion on the right base of labia minora.
The vulval epithelium shows full thickeness loss of squamous maturation. There is significant cellular pleomorphism, presence of atypical mitotic figures and cellular crowding. There is no evidence of stromal invasion.
