High-grade squamous intraepithelial lesion arising adjacent to vulvar lymphangioma circumscriptum: a tertiary institutional experience
Identifieur interne : 001012 ( Main/Exploration ); précédent : 001011; suivant : 001013High-grade squamous intraepithelial lesion arising adjacent to vulvar lymphangioma circumscriptum: a tertiary institutional experience
Auteurs : Go Eun Bae [Corée du Sud] ; Gun Yoon [Corée du Sud] ; Yong Jung Song [Corée du Sud] ; Hyun-Soo Kim [Corée du Sud]Source :
- Oncotarget [ 1949-2553 ] ; 2016.
Abstract
Lymphangioma circumscriptum of the vulva occurs in patients who have undergone radical hysterectomy, lymph node dissection, or radiation therapy for management of advanced uterine cancer. Since vulvar lymphangioma circumscriptum typically presents as multiple, grossly verrucous vesicles of various sizes, it may be impossible to clinically distinguish vulvar lymphangioma circumscriptum from other vulvoperineal cutaneous diseases. In the present study, 16 (1.6%) out of the 1,024 vulvar biopsy or excision specimens were diagnosed as lymphangioma circumscriptum. In two (12.5%) out of the 16 cases, unusual histopathological findings were observed. Both patients had previously undergone radical hysterectomy with lymph node dissection and postoperative radiation therapy or concurrent chemoradiation therapy for advanced cervical cancer. Microscopic examination revealed high-grade squamous intraepithelial lesions, which were located immediately adjacent to the normal squamous epithelium covering the dilated subepithelial lymphatic vessels. Further, human papillomavirus genotyping confirmed that both patients were infected with high-risk human papillomavirus. High-grade squamous intraepithelial lesion cannot be grossly distinguished from vulvar lymphangioma circumscriptum because the multiple, verrucous vesicles that constitute the characteristic gross appearance of vulvar lymphangioma circumscriptum hinder its distinction. In this regard, our cases of high-grade squamous intraepithelial lesion, located adjacent to vulvar lymphangioma circumscriptum, support the notion that active surgical excision is necessary for the treatment of vulvar lymphangioma circumscriptum.
Url:
DOI: 10.18632/oncotarget.10158
PubMed: 27329721
PubMed Central: 5217005
Affiliations:
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Hospital, Pusan National University School of Medicine, Yangsan-si, Gyeongsangnam-do, Republic of Korea</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea> Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan-si, Gyeongsangnam-do</wicri:regionArea><wicri:noRegion>Gyeongsangnam-do</wicri:noRegion></affiliation></author><author><name sortKey="Song, Yong Jung" sort="Song, Yong Jung" uniqKey="Song Y" first="Yong Jung" last="Song">Yong Jung Song</name><affiliation wicri:level="1"><nlm:aff id="A2"> Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan-si, Gyeongsangnam-do, Republic of Korea</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea> Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan-si, 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type="doi">10.18632/oncotarget.10158</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">004265</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">004265</idno><idno type="wicri:Area/Pmc/Curation">004264</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">004264</idno><idno type="wicri:Area/Pmc/Checkpoint">000922</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000922</idno><idno type="wicri:Area/Ncbi/Merge">008456</idno><idno type="wicri:Area/Ncbi/Curation">008456</idno><idno type="wicri:Area/Ncbi/Checkpoint">008456</idno><idno type="wicri:Area/Main/Merge">001014</idno><idno type="wicri:Area/Main/Curation">001012</idno><idno type="wicri:Area/Main/Exploration">001012</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">High-grade squamous intraepithelial lesion arising adjacent to vulvar lymphangioma circumscriptum: a tertiary institutional experience</title><author><name sortKey="Bae, Go Eun" sort="Bae, Go Eun" uniqKey="Bae G" first="Go Eun" last="Bae">Go Eun Bae</name><affiliation wicri:level="3"><nlm:aff id="A1"> Department of Pathology, Graduate School, Kyung Hee University, Seoul, Republic of Korea</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea> Department of Pathology, Graduate School, Kyung Hee University, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author><author><name sortKey="Yoon, Gun" sort="Yoon, Gun" uniqKey="Yoon G" first="Gun" last="Yoon">Gun Yoon</name><affiliation wicri:level="1"><nlm:aff id="A2"> Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan-si, Gyeongsangnam-do, Republic of Korea</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea> Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan-si, Gyeongsangnam-do</wicri:regionArea><wicri:noRegion>Gyeongsangnam-do</wicri:noRegion></affiliation></author><author><name sortKey="Song, Yong Jung" sort="Song, Yong Jung" uniqKey="Song Y" first="Yong Jung" last="Song">Yong Jung Song</name><affiliation wicri:level="1"><nlm:aff id="A2"> Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan-si, Gyeongsangnam-do, Republic of Korea</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea> Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan-si, Gyeongsangnam-do</wicri:regionArea><wicri:noRegion>Gyeongsangnam-do</wicri:noRegion></affiliation></author><author><name sortKey="Kim, Hyun Soo" sort="Kim, Hyun Soo" uniqKey="Kim H" first="Hyun-Soo" last="Kim">Hyun-Soo Kim</name><affiliation wicri:level="3"><nlm:aff id="A3"> Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea</nlm:aff><country xml:lang="fr">Corée du Sud</country><wicri:regionArea> Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul</wicri:regionArea><placeName><settlement type="city">Séoul</settlement><region type="capital">Région capitale de Séoul</region></placeName></affiliation></author></analytic><series><title level="j">Oncotarget</title><idno type="eISSN">1949-2553</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Lymphangioma circumscriptum of the vulva occurs in patients who have undergone radical hysterectomy, lymph node dissection, or radiation therapy for management of advanced uterine cancer. Since vulvar lymphangioma circumscriptum typically presents as multiple, grossly verrucous vesicles of various sizes, it may be impossible to clinically distinguish vulvar lymphangioma circumscriptum from other vulvoperineal cutaneous diseases. In the present study, 16 (1.6%) out of the 1,024 vulvar biopsy or excision specimens were diagnosed as lymphangioma circumscriptum. In two (12.5%) out of the 16 cases, unusual histopathological findings were observed. Both patients had previously undergone radical hysterectomy with lymph node dissection and postoperative radiation therapy or concurrent chemoradiation therapy for advanced cervical cancer. Microscopic examination revealed high-grade squamous intraepithelial lesions, which were located immediately adjacent to the normal squamous epithelium covering the dilated subepithelial lymphatic vessels. Further, human papillomavirus genotyping confirmed that both patients were infected with high-risk human papillomavirus. High-grade squamous intraepithelial lesion cannot be grossly distinguished from vulvar lymphangioma circumscriptum because the multiple, verrucous vesicles that constitute the characteristic gross appearance of vulvar lymphangioma circumscriptum hinder its distinction. In this regard, our cases of high-grade squamous intraepithelial lesion, located adjacent to vulvar lymphangioma circumscriptum, support the notion that active surgical excision is necessary for the treatment of vulvar lymphangioma circumscriptum.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Aggarwal, K" uniqKey="Aggarwal K">K Aggarwal</name></author><author><name sortKey="Gupta, S" uniqKey="Gupta S">S Gupta</name></author><author><name sortKey="Jain, Vk" uniqKey="Jain V">VK Jain</name></author><author><name sortKey="Marwah, N" uniqKey="Marwah N">N Marwah</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Amouri, M" uniqKey="Amouri M">M Amouri</name></author><author><name sortKey="Masmoudi, A" uniqKey="Masmoudi A">A Masmoudi</name></author><author><name sortKey="Boudaya, S" uniqKey="Boudaya S">S Boudaya</name></author><author><name sortKey="Amouri, A" uniqKey="Amouri A">A 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