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Vulvar Squamous Intraepithelial Lesion, HPV-Associated

MedGen UID:
925531
•Concept ID:
C4287999
•
Disease or Syndrome
Synonyms: Vulvar Intraepithelial Neoplasia, HPV-Associated; Vulvar SIL; Vulvar Squamous Intraepithelial Lesion

Definition

An intraepithelial lesion of the vulvar squamous epithelium associated with HPV infection. It is characterized by maturation abnormalities and nuclear hyperchromasia that are confined to the basement membrane. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVVulvar Squamous Intraepithelial Lesion, HPV-Associated

Professional guidelines

PubMed

A six-year experience with anal cytology in women with HPV in the lower genital tract: utility, limitations, and clinical correlation.
Cardinal LH, Carballo P, Lorenzo MC, García A, Suzuki V, Tatti S, Vighi S, Díaz LB
Diagn Cytopathol 2014 May;42(5):396-400. Epub 2013 Oct 25 doi: 10.1002/dc.23050. PMID: 24166879
The Lower Anogenital Squamous Terminology Standardization Project for HPV-Associated Lesions: background and consensus recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology.
Darragh TM, Colgan TJ, Cox JT, Heller DS, Henry MR, Luff RD, McCalmont T, Nayar R, Palefsky JM, Stoler MH, Wilkinson EJ, Zaino RJ, Wilbur DC; Members of LAST Project Work Groups
J Low Genit Tract Dis 2012 Jul;16(3):205-42. doi: 10.1097/LGT.0b013e31825c31dd. PMID: 22820980

Recent clinical studies

Etiology

Comorbid Vulvar Lichen Sclerosus and High-Grade Squamous Intraepithelial Lesions: A Management Conundrum.
Janke MJ, DeBlanc J, Kobernik EK, Skala SL, Hiles GL, Kelly R, Welch KC
J Low Genit Tract Dis 2022 Oct 1;26(4):319-322. Epub 2022 Aug 15 doi: 10.1097/LGT.0000000000000690. PMID: 35972920
Putative precancerous lesions of vulvar squamous cell carcinoma.
Jenkins TM, Mills AM
Semin Diagn Pathol 2021 Jan;38(1):27-36. Epub 2020 Sep 6 doi: 10.1053/j.semdp.2020.09.006. PMID: 32948383
HPV-independent Precursors Mimicking High-grade Squamous Intraepithelial Lesions (HSIL) of the Vulva.
Rakislova N, Alemany L, Clavero O, Del Pino M, Saco A, Marimon L, Quirós B, Lloveras B, Ribera-Cortada I, Alejo M, Pawlita M, Quint W, de Sanjose S, Ordi J; VVAP Study Group
Am J Surg Pathol 2020 Nov;44(11):1506-1514. doi: 10.1097/PAS.0000000000001540. PMID: 32657782
Vulvar and Anal Intraepithelial Neoplasia: Terminology, Diagnosis, and Ancillary Studies.
Yang EJ, Kong CS, Longacre TA
Adv Anat Pathol 2017 May;24(3):136-150. doi: 10.1097/PAP.0000000000000149. PMID: 28398952
Nature of cervical cancer and other HPV - associated cancers.
Georgieva S, Iordanov V, Sergieva S
J BUON 2009 Jul-Sep;14(3):391-8. PMID: 19810128

Diagnosis

Comorbid Vulvar Lichen Sclerosus and High-Grade Squamous Intraepithelial Lesions: A Management Conundrum.
Janke MJ, DeBlanc J, Kobernik EK, Skala SL, Hiles GL, Kelly R, Welch KC
J Low Genit Tract Dis 2022 Oct 1;26(4):319-322. Epub 2022 Aug 15 doi: 10.1097/LGT.0000000000000690. PMID: 35972920
Putative precancerous lesions of vulvar squamous cell carcinoma.
Jenkins TM, Mills AM
Semin Diagn Pathol 2021 Jan;38(1):27-36. Epub 2020 Sep 6 doi: 10.1053/j.semdp.2020.09.006. PMID: 32948383
Vulval squamous cell carcinoma and its precursors.
Singh N, Gilks CB
Histopathology 2020 Jan;76(1):128-138. doi: 10.1111/his.13989. PMID: 31846523
HPV-related vulvar diseases and perspectives of p16INK4a immunochemistry: a review of the literature.
Carrone A, Riganelli L, Savone D, Casorelli A, Merlino L, Pecorini F, Pecorella I, Mancino P, Piccioni MG, Benedetti Panici P
Tumori 2017 Nov 23;103(6):511-515. Epub 2017 May 26 doi: 10.5301/tj.5000642. PMID: 28574130
Vulvar and Anal Intraepithelial Neoplasia: Terminology, Diagnosis, and Ancillary Studies.
Yang EJ, Kong CS, Longacre TA
Adv Anat Pathol 2017 May;24(3):136-150. doi: 10.1097/PAP.0000000000000149. PMID: 28398952

Therapy

Loss of MHC Class I Expression in HPV-associated Cervical and Vulvar Neoplasia: A Potential Mechanism of Resistance to Checkpoint Inhibition.
Dibbern ME, Bullock TN, Jenkins TM, Duska LR, Stoler MH, Mills AM
Am J Surg Pathol 2020 Sep;44(9):1184-1191. doi: 10.1097/PAS.0000000000001506. PMID: 32496434
The impact of HIV antiviral therapy on human papillomavirus (HPV) infections and HPV-related diseases.
Heard I, Palefsky JM, Kazatchkine MD
Antivir Ther 2004 Feb;9(1):13-22. PMID: 15040532
Bowenoid papulosis of the vulva-immunotherapeutical approach with topical imiquimod.
Richter ON, Petrow W, Wardelmann E, Dorn C, Kupka M, Ulrich U
Arch Gynecol Obstet 2003 Oct;268(4):333-6. Epub 2003 Jan 23 doi: 10.1007/s00404-002-0385-5. PMID: 14504882
Immunohistochemical localization of telomerase hTERT protein and analysis of clonality in multifocal vulvar intraepithelial neoplasia.
Wada H, Enomoto T, Yoshino K, Ozaki K, Kurachi H, Nomura T, Murata Y, Kim N, Weinrich S, Lea-Chou E, Lopez-Uribe D, Shroyer KR
Am J Clin Pathol 2000 Sep;114(3):371-9. doi: 10.1093/ajcp/114.3.371. PMID: 10989637

Prognosis

Putative precancerous lesions of vulvar squamous cell carcinoma.
Jenkins TM, Mills AM
Semin Diagn Pathol 2021 Jan;38(1):27-36. Epub 2020 Sep 6 doi: 10.1053/j.semdp.2020.09.006. PMID: 32948383
Vulval squamous cell carcinoma and its precursors.
Singh N, Gilks CB
Histopathology 2020 Jan;76(1):128-138. doi: 10.1111/his.13989. PMID: 31846523
Differentiated Vulvar Intraepithelial Neoplasia-like and Lichen Sclerosus-like Lesions in HPV-associated Squamous Cell Carcinomas of the Vulva.
Rakislova N, Alemany L, Clavero O, Del Pino M, Saco A, Quirós B, Lloveras B, Alejo M, Halec G, Quint W, de Sanjosé S, Ordi J; VVAP study group
Am J Surg Pathol 2018 Jun;42(6):828-835. doi: 10.1097/PAS.0000000000001047. PMID: 29505429
Role of Human Papillomavirus in Vulvar Cancer.
Rakislova N, Saco A, Sierra A, Del Pino M, Ordi J
Adv Anat Pathol 2017 Jul;24(4):201-214. doi: 10.1097/PAP.0000000000000155. PMID: 28590952
Pathways of vulvar intraepithelial neoplasia and squamous cell carcinoma.
Del Pino M, Rodriguez-Carunchio L, Ordi J
Histopathology 2013 Jan;62(1):161-75. Epub 2012 Nov 27 doi: 10.1111/his.12034. PMID: 23190170

Clinical prediction guides

The First Human Vulvar Intraepithelial Neoplasia Cell Line with Naturally Infected Episomal HPV18 Genome.
Wu M, Zhang X, Kang Y, Zhu Y, Su Z, Liu J, Zhang W, Chen H, Li H
Viruses 2022 Sep 16;14(9) doi: 10.3390/v14092054. PMID: 36146860Free PMC Article
Interobserver reproducibility of the diagnosis of differentiated exophytic vulvar intraepithelial lesion (DEVIL) and the distinction from its mimics.
Neville G, Chapel DB, Crum CP, Song SJ, Yoon JY, Lee KR, Kolin DL, Hirsch MS, Nucci MR, Parra-Herran C
Histopathology 2021 Dec;79(6):957-965. Epub 2021 Sep 3 doi: 10.1111/his.14442. PMID: 34214216
PD-L1 and IDO expression in cervical and vulvar invasive and intraepithelial squamous neoplasias: implications for combination immunotherapy.
Chinn Z, Stoler MH, Mills AM
Histopathology 2019 Jan;74(2):256-268. Epub 2018 Oct 29 doi: 10.1111/his.13723. PMID: 30067880
Differentiated Vulvar Intraepithelial Neoplasia-like and Lichen Sclerosus-like Lesions in HPV-associated Squamous Cell Carcinomas of the Vulva.
Rakislova N, Alemany L, Clavero O, Del Pino M, Saco A, Quirós B, Lloveras B, Alejo M, Halec G, Quint W, de Sanjosé S, Ordi J; VVAP study group
Am J Surg Pathol 2018 Jun;42(6):828-835. doi: 10.1097/PAS.0000000000001047. PMID: 29505429
Recent developments in vulvovaginal pathology.
McCluggage WG
Histopathology 2009 Jan;54(2):156-73. doi: 10.1111/j.1365-2559.2008.03098.x. PMID: 18637148

Recent systematic reviews

Chromosomal gains and losses in human papillomavirus-associated neoplasia of the lower genital tract - a systematic review and meta-analysis.
Thomas LK, Bermejo JL, Vinokurova S, Jensen K, Bierkens M, Steenbergen R, Bergmann M, von Knebel Doeberitz M, Reuschenbach M
Eur J Cancer 2014 Jan;50(1):85-98. Epub 2013 Sep 17 doi: 10.1016/j.ejca.2013.08.022. PMID: 24054023

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