# name
Differentiated Vulvar Intraepithelial Neoplasia-like and Lichen
                Sclerosus-like Lesions in HPV-associated Squamous Cell
                Carcinomas of the Vulva

# metadata.dc.description.abstract[].value
Most human papillomavirus (HPV)-associated vulvar squamous cell
                carcinomas (VSCCs) originate from high-grade squamous
                intraepithelial lesions, also named usual type vulvar
                intraepithelial neoplasia. However, growing evidence suggests
                that morphologic studies have limitations in predicting HPV
                status in vulvar lesions. We aimed to evaluate adjacent
                intraepithelial lesions in a series of DNA HPV-positive VSCCs,
                focusing on unusual histologic patterns mimicking differentiated
                vulvar intraepithelial neoplasia (dVIN) or lichen sclerosus
                (LS). We identified 326 DNA HPV-positive VSCC with at least 1 cm
                of skin adjacent to the invasive tumor and analyzed HPV typing,
                HPV E6*I mRNA, and p16 immunohistochemistry in all cases. A
                careful histologic evaluation was conducted. A conclusive
                association with HPV was based on a positive p16 or HPV E6*I
                mRNA result or both in addition to the HPV DNA, whereas cases
                negative for both markers were classified as nonconclusively
                associated with HPV. One hundred twenty-one tumors (37.1%) had
                normal adjacent skin, 191 (58.6%) had only high-grade squamous
                intraepithelial lesions, also named usual type vulvar
                intraepithelial neoplasia, and unusual intraepithelial lesions
                were identified in 14 (4.3%) tumors. Seven cases showed
                dVIN-like features, 5 showed adjacent LS-like lesion, and in 2
                cases dVIN-like and LS-like lesions were identified
                simultaneously. Six of them were conclusively associated with
                HPV (3 dVIN-like, 2 LS-like, 1 with combined dVIN/LS-like
                features). All 6 tumors were associated with HPV16 and were
                positive for both p16 and HPV mRNA, and p16 was also positive in
                the dVIN-like and LS-like lesions. In summary, a small subset of
                VSCCs conclusively associated with HPV may arise on
                intraepithelial lesions, mimicking precursors of HPV-independent
                VSCC.

# metadata.dc.relation.isformatof[].value
Versió postprint del document publicat a:
                http://dx.doi.org/10.1097/PAS.0000000000001047

# metadata.dc.relation.ispartof[].value
The American Journal of Surgical Pathology, 2018, vol 42, num. 6, p. 828-835

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

# metadata.dc.title[].value
Differentiated Vulvar Intraepithelial Neoplasia-like and Lichen
                Sclerosus-like Lesions in HPV-associated Squamous Cell
                Carcinomas of the Vulva