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usual vulvar intraepithelial neoplasia

Friday 10 March 2017

uVin; u-VIN

Definition: The term vulvar intraepithelial neoplasia (VIN) introduced in 1986 incorporates 3 grades of usual VIN (u-VIN I-III) and the differentiated VIN (d-VIN).

Although u-VIN is etiologically associated with the human papillomavirus (HPVs) infection, d-VIN represents an alternative HPV negative pathway of vulvar carcinogenesis.

In 2004, the u-VIN I category was abandoned and u-VIN II and III were merged. Further, an alternative Bethesda-like terminology scheme presenting the term vulvar intraepithelial lesion was proposed recently.

On the basis of histologic features, vulvar intraepithelial neoplasia (VIN) has been subdivided into the usual (u-VIN) and differentiated (d-VIN) types.

u-VIN is associated with HPV and occurs preferentially in young women at reproductive age. It has been further assorted into warty, basaloid, and mixed subtypes and subclassified into 3 grades (u-VIN I, II, and III).

d-VIN affects mainly postmenopausal women and behaves as a carcinoma in situ with a considerable risk of progression into invasive, mostly well differentiated and keratinizing HPV negative SCC.

References

- Skapa P, Zamecnik J, Hamsikova E, Salakova M, Smahelova J, Jandova K, Robova H, Rob L, Tachezy R. Human papillomavirus (HPV) profiles of vulvar lesions: possible implications for the classification of vulvar squamous cell carcinoma precursors and for the efficacy of prophylactic HPV vaccination. Am J Surg Pathol. 2007 Dec;31(12):1834-43. PMID: 18043037