Handan ÇETİNER, Gözde KIR, Mustafa SAKALLI, Ateş KARATEKE

Zeynep kamil hastanesinde 2000-2006 yılları arasında tanı almış vulvar neoplaziler ve preneoplastik lezyonların dökümü

Amaç: Vulvar lezyonların genital sistem içerisinde nispeten seyrek görülmesi nedeniyle, bu bölgeye ait arşiv materyalini gözden geçirmeyi ve sınıflandırmayı ve bazı nadir görülen olguları literatür bilgileri ışığında tartışmayı amaçladık. Yöntem ve Bulgular: Zeynep Kamil Hastanesi Patoloji Laboratuarının 2000-2006 yılaarı arasındaki arşivinde yer alan 94 vulvar lezyonun hematoksilen-eosin (H-E) boyalı ve gerekiyorsa immunohistokimyasal olarak boyanmış kesitleri incelendi.Olguların 15 I malign, 57 si benign ve 22 adeti de premalign sınıfında yer almakta idi. Malign tümörlerin de; 9 adeti skuamöz hücreli karsinom, 4 adeti malign melanom, 1 adeti bazal hücreli karsinom ve 1 adeti de PNET/Ewing tümörü idi. Yorum: Vulvar lezyonlar nispeten seyrek görülen, özellikle differensiye VİN gibi bazı formları da tanı ve tedavisi oldukça zor ve tartışmalı lezyonlardır. Bu nedenle daha fazla olgu içeren çalışmaların yapılmasının yararlı olacağı düşünülmektedir.

All vulvar neoplasms and preneoplastic lesions which were diagnosed in Zeynep Kamil hospital between 2000-2006 years

Aim: Benign and especially malign and premalign lesions of vulva are relatively infrequent in gyneocologic system lesions.Because of its infrequency we aimed to review and classify archival material of this area and discuss some diagnostically important and some rarely seen cases under the light of literature. Methods and Results:We reviewed archival material of 94 cases in Zeynep Kamil Hospital Pathology Laboratory.Hematoxylin-Eosin(HE) sections and if needed immunohistochemically stained sections of the cases have been re-examined.There were 15 cases of malign tumors, 57 cases of benign tumors and 22 cases of premalign lesions.Of malign tumors; 9 cases were squamous carcinoma, 4 cases were malign melanoma, 1 case was basal cell carcinoma and 1 case was PNET/Ewing Conclusion: Since the vulvar lesions are infrequently seen lesions and some of them are like differentiated VIN, really hard to diagnosis, there may be need further studies involving a large number of cases

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1) Prat J Female reproductive system.In:Damjanov I, Linder J, editors. Anderson’s Pathology, 10th ed. Philadelphia: Mosby, 1996:2231-2309.
2) Husseinzadeh N, Wesseler T, Schneider D, Schellas H, Nahhas W: Prognostic factors and the significance of cytologic grading in invasive squamous cell carcinoma of the vulva:clinicopathologic study.Gynaecol Oncol 36:192-199,1990
3) Ansink A, Heinz A. Epidemiology and aetiology of squamous cell carcinoma of the vulva. Eur J Obs Gynaecol Reprod B iol 48:111-115,1993
4) Stoler MH, Mills SE, Frierson HF JR. The vulva and vagina. In: Carter D, Greenson JK, Oberman HA, Reuter V, Stoler MH eds. Sternberg’s diagnostic and surgical pathology. 4th ed. Philadelphia: Lippincott Williams & Wilkins, 2004: 2333-2376.
5) Japaze H, Dinh T V, Woodruff J D. Verrucous carcinoma of the vulva: study of 24 cases. Obs and Gynecol 60:462-466,1982
6) Fox H, Buckley CH.Neoplastic diseases of the vulva and associated structures. In:Fox H, Wells M eds.Obstetrical and Gynaecological Pathology. 5th ed.London: Churchill Livingstone, 2003: 95-146.
7) Pierson KK. Malignant melanomas and pigmented lesions of the vulva. In: Wilkinson EJ (ed) Pathology of the vulva and vagina. Churchill Livingstone, 1987, New York, pp155-179.
8) Bradgate M G, Rollason T P, McConkey C, Powell J. Malignant melanoma of the vulva: a clinicopathological study of 30 women. British J of Obstet and Gynecol 97:124-133,1990
9) Wilkinson JW.Premalignant and malignant tumors of the vulva.In: Kurman RJ, ed. Blaustein’s Pathology of the Female Genital Tract. 5th ed.New York: Springer-Verlag, 2002: 99-149.
10) Vang R, Tauberger JK, Mannion JM et al.Primary vulvar and vaginal extraosseousEwing’s Sarcoma/Peripheral Neuroektodermal Tumor: Diagnostic confirmation with CD99 immunstaining and reverse transcriptasem-polymerase chain reaction. Int J Gynecol Pathol 19(2):103-109,April 2000
11) Scherr G, D’abling III G,Ouzounian J.Peripheral primitive neuroectodermal tumor of the vulva. Gynecol Oncol 54:254-258,1994
12) (abs)Parades E, Duarte A, Coucerio A et al. A peripheral neuroectodermal tumor of the vulva. Acta Med Port 8(3): 161-163,1995
13) (abs)Takeshima N, Tabata T, Nishida H et al.Peripheral primitive neuroectodermal tumor of the vulva: report of case with imprint cytology. Acta Cytol45(6):1049-1052,Nov-Dec 2001
14) (abs)Lazura T, Alsanad IA, Meuric S et al. Primary uterin and vulvar Ewing’s sarcoma/PNET in children :two unusual locations. Ann Pathol 21(3): 263-266,Jun 2001
15) (abs)Habib K, Finet JF, Plantier F et al. Rare lesion of the vulva. Arch Anat Cytol Pathol 40(2-3):158-159,1992
16) Weidner N, Tjoe J. Immunohistochemical profile of monoclonal antibody O13:antibody that recognizes glycoprotein p30/32 MIC2 and is useful in diagnosing Ewing’s sarcoma and peripheral neuroepithelioma. Am J of Surg Pathol 18(5):486-494, 1994
17) Lee CS, Southey MC, Waters K, Kannourakis G, Georgiou T, Armes JE, Chow CW, Venter DJ. EWS/FLI-1 fusion transcript detection and MIC2 immunhistochemical staining in the diagnosis of Ewing’s sarcoma.Pediatr Pathol Lab Med 16:379-392,1996
18) Polat A, Aydın Ö, Düşmez. Mersin ilinde 1989-1999 yılları arasında görülen kadın genital sistem tümörlerinin dağılımının değerlendirilmesi.Türk Patoloji Dergisi 16(1-2):34-38,2000
19) Haefner HK, Tate JE, McLachlin CM, Crum CP. Vulvar intraepithelial neoplasia: Age, morphological phenotype, papillomavirus DNA and coexisting invasive carcinoma. Human Pathol 26(2): 147-154,1995
20) Yang B, Hart WR. Vulvar intraepithelial neoplasia of the simplex (differentiated) type A clinicopathologic study including analysis of HPV and p53 expression. Am J Surg Pathol 24(3):429-441,2000