外阴赘生物两年。

PE：阴蒂及双侧小阴唇融合、增生。

 考虑鳞癌。年龄?

所给图像太局限， 给低倍，有HPV感染

有HPV感染，细胞核异形性大，考虑为高级别上皮内瘤变，图像少，不好具体诊断。

 年龄是57岁，两年前病检结果为：疣状瘤。

名称：图1
描述：3961_3981_0009.jpg.jpg

名称：图2
描述：3961_3981_0008.jpg.jpg

名称：图3
描述：3961_3981_0007.jpg.jpg

   似乎仍旧无法完全肯定是癌！图片上需要注意由切片角度所带来的陷阱！！

考虑为病毒感染吗？

核的异型性比HPV感染引起的异型性大。个人认为符合早期鳞癌。

上皮内瘤变，浸润与否这么看不好判断。

有HPV感染。那些呈巢的是癌还是增生呢？细胞很吓人，组织结构呢？

上皮内瘤变，无法完全肯定是癌！

HPV感染，确认鳞癌还需低倍镜，上皮内瘤变是肯定的

 I think it is an invasive squamous cell carcinoma. But I have couple suggestions for you. First please provide some essential patients information, such as age and clinical presentation (a mass or not). Second, please try to provide a low power view of this lesion. The reason I ask you is because there are two different types of VIN, simplex and classic types. These information will be extremely helpful to think which type of this cancer may be derived from. I hope this is helpful to you.