# name
HPV-independent Precursors Mimicking High-grade Squamous intraepithelial Lesions (HSIL) of the Vulva

# metadata.dc.description.abstract[].value
Two etiopathogenic types of vulvar squamous cell carcinoma (VSCC) have been described: human papillomavirus (HPV)-associated and HPV-independent. Precursor lesions, frequently identified in the adjacent skin, are also distinct in  the 2 types of VSCC: high-grade squamous intraepithelial lesions
                (HSILs) in HPV-associated VSCC and differentiated vulvar
                intraepithelial neoplasia (dVIN) or vulvar acanthosis with
                altered differentiation in HPV-independent VSCC. Although
                HPV-independent precursors mimicking HSIL have been described in
                the vulva, their frequency and morphologic spectrum have not
                been completely characterized. We explored, in a large series of
                HPV-independent VSSC, the frequency and the histologic features
                of precursors mimicking HSIL. We included 779 DNA
                HPV-negative/p16-negative VSCC with at least 1\xE2\x80\x89cm of
                adjacent skin. We evaluated the histologic and
                immunohistochemical (p16 and p53) characteristics of the
                intraepithelial lesions, focusing on precursors mimicking
                HPV-associated vulvar HSIL. A total of 254 tumors (33%) had
                adjacent premalignant lesions. Of them, 186 (73%) had dVIN, 22
                (9%) had vulvar acanthosis with altered differentiation, and 46
                (18%) had lesions that mimicked HSIL. The mean age of the
                patients with these HSIL-like lesions was 72\xC2\xB115 years.
                Twenty-six of these HSIL-like lesions had basaloid morphology,
                13 warty, and 7 mixed basaloid/warty features. All the HSIL-like
                precursors were DNA HPV-negative/p16-negative; 74% of them
                showed p53 abnormal staining and 35% of them had areas of
                conventional dVIN. In conclusion, about one fifth of the
                HPV-independent precursors mimic HSIL, showing either basaloid
                or warty features. Older age and the presence of areas of
                typical HPV-independent intraepithelial lesions, together with
                p16 negativity, should raise suspicion of an HPV-independent
                etiology.

# metadata.dc.relation.ispartof[].value
American Journal of Surgical Pathology, 2020, vol 44, num 11, p. 1506-1514

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
HPV-independent Precursors Mimicking High-grade Squamous intraepithelial Lesions (HSIL) of the Vulva