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- ‘外阴白斑’活检1例（VINIII第二次手术标本病理会诊报告 2010-09-29）
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本帖最后由 于 2010-09-28 21:30:00 编辑
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| 以下是引用wfbjwt在2010-9-14 18:22:00的发言： 鲍温病、派杰病、浅表恶黑鉴别。 |
wfbjwt
Review for Bowen's Disease
Bowen's disease (BD) (also known as "squamous cell carcinoma in situ"[1]:655) is a neoplastic skin disease, it can be considered as an early stage or intraepidermal form of squamous cell carcinoma. It was named after Dr John T. Bowen, the doctor who first described it in 1912. Erythroplasia of Queyrat is a form of squamous cell carcinoma in situ arising on the glans or prepuce, possibly induced by HPV.[2]
Causes
Causes of BD include solar damage, arsenic, immunosuppression (including AIDS), viral infection (human papillomavirus or HPV) and chronic skin injury and dermatoses.
Signs and symptoms
Bowen's disease typically presents as a gradually enlarging, well demarcated erythematous plaque with an irregular border and surface crusting or scaling. BD may occur at any age in adults but is rare before the age of 30 years - most patients are aged over 60. Any site may be affected, although involvement of palms or soles is uncommon. BD occurs predominantly in women (70-85% of cases). About 60-85% of patients have lesions on the lower leg, usually in previously or presently sun exposed areas of skin.
This is a persistent progressive non-elevated red scaly or crusted plaque which is due to an intraepidermal carcinoma and is potentially malignant. The lesions may occur anywhere on the skin surface or on mucosal surfaces. Freezing, cauterization or diathermy coagulation is often effective treatment.
Histology
Bowen's disease is essentially equivalent to squamous cell carcinoma in situ. Atypical squamous cells proliferate through the whole thickness of the epidermis. The entire tumor is confined to the epidermis and does not invade into the dermis. The cells in Bowen's are often highly atypical under the microscope, and may in fact look more unusual than the cells of some invasive squamous cell carcinomas.
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- 三十功名尘与土，八千里路云与月。
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Rewiew for Vulvar Intraepithelial Neoplasia VIN
The term Vulvar intraepithelial neoplasia (VIN) refers to particular changes that can occur in the skin that covers the vulva. VIN is not cancer, and in some women it disappears without treatment. If the changes become more severe, there is a chance that cancer might develop after many years, and so it is referred to as a precancerous condition.
ISSVD Classification
Medically speaking, the term denotes a squamous intraepithelial lesion of the vulva that shows dysplasia with varying degrees of atypia. The epithelial basement membrane is intact and the lesion is thus not invasive but has invasive potential.
The terminology of VIN evolved over several decades. In 1989[2] the Committee on Terminology, International Society for the Study of Vulvar Disease (ISSVD) replaced older terminology such as vulvar dystrophy, Bowen's disease, and Kraurosis vulvae by a new classification system for Epithelial Vulvar Disease:
Nonneoplastic epithelial disorders of vulva and mucosa:
Lichen sclerosus
Squamous hyperplasia
Other dermatoses
Mixed neoplastic and nonneoplastic disorders
Intraepithelial neoplasia
Squamous vulvar intraepithelial neoplasia (VIN)
VIN I, mildest form
VIN II, intermediate
VIN III, most severe form including carcinoma in situ of the vulva
Non-squamous intraepithelial neoplasia
Extramammary Paget's disease
Tumors of melanocytes, non invasive
Invasive disease (vulvar carcinoma)
Diagnosis
The patient may have no symptoms, or local symptomatology including itching, burning, and pain. The diagnosis is always based on a careful inspection and a targeted biopsy.
Treatment
The treatment of VIN is local to wide excision, in case of very extensive involvement or recurrency even a simple vulvectomy. Laser therapy has also been useful for VIN.
Additional images:
Micrograph of vulvar intraepithelial neoplasia III or Grade 3 (VIN 3). H&E stain.
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- 三十功名尘与土，八千里路云与月。
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(Squamous) vulval (or vulvar) intraepithelial neoplasia (VIN) is a pre-cancerous skin lesion of the vulva, and was previously known as Bowen's disease of the vulva.
The presence of abnormal cells may occur anywhere on the vulvar skin. VIN is not invasive cancer but may eventually become invasive squamous cell cancer if left untreated.
In 2004, the International Society for the Study of Vulvovaginal Diseases (ISSVD) has reclassified VIN. The term VIN 1, previously used to describe a mild change in the lower epithelial lining, will no longer be used - these changes have been found to be due to irritation or non-precancerous viral wart infection. The term VIN now refers to high grade abnormal squamous lesions only (these were previously known as VIN 2 and VIN 3).
VIN (usual type) can be described by the pathologist as warty, basaloid or mixed. These types of VIN are due to infection with cancer-forming (oncogenic) types of human papillomavirus.
A less common ‘differentiated’ type of VIN is not caused by human papillomavirus and is associated with rapidly growing squamous cell carcinoma.
VIN, unclassified type, is rare and is of unknown origin.
很抱歉，没有太多的时间来翻译它们。不是很难懂的，让我们大家一起来学习或复习吧。
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- 三十功名尘与土，八千里路云与月。
