Background Hidradenoma papilliferum (HP) is a benign tumor that primarily affects the anogenital area of adult women. Previously considered apocrine tumors, anogenital HP tumors are now interpreted ...as adenomas of mammary-like anogenital glands based on their histologic features. Objective This clinical study was undertaken to determine whether vulvar HP is located on mammary-like anogenital gland sites and to describe its morphologic features. Methods The clinical photographs of 52 histologically confirmed vulvar HP provided by 7 vulva specialists were analyzed. Results In all, 90.4% of the HP were located on the interlabial sulcus, adjacent zone, or the perineum. These tumors were polymorphous in terms of number (1 or multiple), size (<1-4.5 cm), color (pink, red, blue), surface (ulcerated or not), and architecture (unilobular or multilobular). Limitations Eight histologic reports could not be reviewed by the authors but the contributors confirmed that the photographs sent were only those of histologically confirmed HPs. Conclusions Vulvar HP is mainly located on mammary-like anogenital gland sites, thereby providing further evidence to their histogenesis. Although a nonulcerated or ulcerated tumor of the interlabial sulcus should evoke a HP diagnosis, the latter must be confirmed histologically.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
We report 2 cases of a foreign body reaction to Radiesse, a semipermanent soft-tissue filler consisting of 30% calcium hydroxylapatite microspheres and 70% carboxymethyl cellulose gel carrier. In one ...case, injection of this filler provoked a nodule on the columella, which was discovered during rhinoplasty. In the second case, the reaction was revealed during histopathologic examination of the deep section of a surgically removed basal-cell carcinoma. Histopathology showed a foreign body reaction with numerous giant cells and histiocytes, some plasma cells, and lymphocytes. Within this inflammatory reaction, a nonpolarizing exogenous material was identified consisting of numerous, round, uniformly sized, yellowish, extracellular deposits with a crackled appearance. Although many authors claim that Radiesse does not induce any foreign body reactions, we found a number of similar histopathologic pictures in studies describing animal or human auricular area test sites or even in reports of lip nodules, which are a well-known adverse effect after injection of this filler into this site. The histopathologic appearance of Radiesse is particularly distinctive and easily recognizable by dermatologists and dermatopathologists.
Vulvar squamous cell carcinoma arises from precursor lesions: vulvar intraepithelial neoplasias (VIN). Most of them are caused by the human papillomavirus (HPV), and the precursor lesion for this ...group is VIN usual type/high grade squamous intraepithelial lesion (uVIN/HSIL) of variable clinical presentation and having a light invasive potential. Some VIN are HPV-independent and arise in older women against the background of chronic dermatoses, mostly lichen sclerosus. Their histological diagnosis is more subtle. They have a higher invasive potential. A third precursor, leading to well-differentiated, or even verrucous, carcinomas, is still ill-defined to this day. We detail these lesions' clinics, histology, and biomarkers (immunohistochemical and molecular).
The vulva is the transition zone between the skin and the lower genital tract. As such, it presents histological specificities, comprises physiological modifications which are specific to it and is ...characterized by particular artifacts. Knowledge of them prevents many questions or even diagnostic errors.
Background
Plasma cell gingivitis is defined as gingival inflammation comprised of plasma cell infiltrates. This diagnostic criterion is non-specific and underlying mechanisms remain unknown.
...Objectives
We performed a multidisciplinary clinico-pathological review of cases previously identified as “gingivitis with plasma cell infiltrates”, with assessment of putative contributing factors and critical appraisal of the final diagnosis.
Materials & Methods
Cases previously identified as “gingivitis with plasma cell infiltrates” between 2000 and 2020 were included from archives from the GEMUB group, a French multidisciplinary network of physicians with expertise on oral mucosa.
Results
Among the 37 included cases, multidisciplinary clinico-pathological review allowed differential diagnosis in seven cases (oral lichen planus
n
=4, plasma cell granuloma
n
=1, plasmacytoma
n
=1, and mucous membrane pemphigoid
n
=1). The remaining cases were classified as “reactive plasma cell gingivitis” (induced by drugs, trauma/irritation or periodontal disease) (
n
=18) or “idiopathic plasma cell gingivitis” when no contributing factors were identified (
n
=12). Clinico-pathological characteristics did not differ significantly between “reactive” and “idiopathic” cases, preventing us from identifying specific features of “idiopathic” plasma cell gingivitis.
Conclusion
“Plasma cell gingivitis” is a polymorphous, non-specific entity with various aetiologies, of which the diagnosis requires multidisciplinary anatomo-clinical correlation for exclusion of secondary causes of plasma cell infiltration. Although our study was limited by its retrospective design, most cases of “plasma cell gingivitis” appeared to be associated with an underlying cause. We propose a diagnostic algorithm to properly investigate such cases.
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EMUNI, FIS, FZAB, GIS, KILJ, MFDPS, SBJE, SBMB, SBNM, UKNU, UM, UPUK, VKSCE
Incidental finding of vascular invasion has been described in some benign granular cell tumours. Malignancy in granular cell tumours is excessively rare and its assessment relies on necrosis and ...cytological criteria.
To assess histopathological invasive features, particularly vascular invasion, in a large series of granular cell tumours of the skin.
119 granular cell tumours of the skin were collected in 114 patients between 2001 and 2011. Histopathological and epidemiological data were collected. Five step sections and one orcein staining were performed in all cases.
Mean age of the patients was 43.7±18 years. Granular cell tumours were multiple in 7% of patients. They were classified as benign in 111 cases, and atypical in eight cases. No malignant granular cell tumour was present. Tumours had 1.48±1.3 cm mean diameter, showed peripheral invasive growth pattern in 71% of cases, had a mean depth of 8.8±4.7 mm, and reached the subcutis in 66% of cases. Infiltration of arrector pili muscle occurred in 23% (95% CI 16% to 32%), and perineural spread in 66% (95% CI 56% to 74%) of cases. Vascular invasion occurred in 23% (95% CI 16% to 32%) of cases, with subendothelial layers infiltration or vascular obliteration. No intraluminal embolus was found. No association was found between vascular invasion and clinical outcome.
Histopathological features of local invasion are frequent in otherwise benign granular cell tumours. Vascular invasion consists of an infiltration of the subendothelial layers, without intraluminal cells, and may not be considered as a marker of adverse prognosis.
The authors report the histopathologic and ultrastructural features of gold threads, which were implanted in the cheek subcutis of a 77-year-old woman 10 years ago. These particles did not give rise ...to any adverse reactions and were fortuitously discovered by the surgeon during a facelift. Histopathology showed a nonpolarizing exogenous material consisting of black oval structures surrounded by a capsule of fibrosis and by a discrete inflammatory reaction with a few giant cells. In some cases, only a long fibrous tract surrounded by a moderate mononucleate infiltrate was observed. The wires were characterized with scanning electron microscopy, and X-ray microanalysis revealed a specific peak at 2.2 keV representative of gold that was absent in the control skin sample. As this value is specific for gold, it confirms the presence of the metal in the patient's skin. The histopathologic appearance of gold threads is particularly distinctive and easily recognizable by dermatopathologists.
A vulvar verruciform xanthoma Liddell, Charly; Plantier, Françoise
Annales de pathologie,
01/2022, Volume:
42, Issue:
1
Journal Article
Peer reviewed
We report a case of a vulvar verruciform xanthoma. Verruciform xanthoma is a rare benign lesion that occurs most commonly on the oral and genital mucosa. Under the microscope, this lesion displays ...acanthotic papillary epidermis with parakeratosis that extends deep into the epithelium, elongated rete ridges and xanthomatous cells in the papillary dermis. Vulvar lesions almost always occur in a local pathological context (lichen planus or sclerosus). It is important to be aware of this entity as it can mimic squamous carcinoma.
Vulvar melanoma is a rare tumour, of poorly known pathogenesis, which presents particularities compared to cutaneous melanoma: more frequently achromic and very often multifocal, it is of the ...lentiginous histological type (MLM), with in half of the cases lentiginous melanocytic hyperplasia at a distance.
This article presents the different pigmented lesions of the vulva (PLV) that are systematically found in 8 to 12% of women and are most often ignored. The histological aspect of physiological ...pigmentation and its modifications due to hormonal impregnation should be known by pathologists in order to better understand the very large variety of lesions.
