Pathology/please help me interpret
QUESTION: Please interpret this biopsy result. I have had lichen sclerosis for 25 years. Squamous hyperplasia, hyperkeratosis and focal squamous atypia. Focal vin can not be excluded. Ki-67/p16 stains performed with appropriate controls. P16 is negative and Ki-67 shows mild increase in cell proliferation
The biopsy from the vulva shows that there is a thickening of the lining epithelium (squamous hyperplasia). In
addition there is increased keratin production by the cells leading to hyperkeratosis.
Some of the cells are atypical, that is they are in between perfectly normal cells and cancer cells.
Specific markers done: Ki-67 - there is mild increase in cell proliferation, this indicates the cells are growing at a mild rate (not enough for cancer which is high proliferation).
p16 is done to evaluate for HPV infection which is associated with VIN and can lead to development of cancer. p16 is negative shooing absence of the virus.
However the pathologist is not sure that the lesion is indeed VIN (Vulvar intraepithelial neoplasm)
Your physician will decide on further course of action, medical and surgical treatments are available.
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QUESTION: My routine gyno did the biopsy. I have been seeing a gynecologist who specializes in vaginitis and lichen sclerosis. He will see me on Monday. He wants to biopsy a larger area. When he sees me on Monday, he will decide whether he will do the biopsy then or send me to a gynocolic oncologist. I have had 5 biopsies over the past 25 years. This is the first time that the results showed atypia. What is the difference between precancerous and cancerous. How do you know if it will become cancerous? What can be done to prevent it from becoming cancerous? I have been using protopic and halobetosal for several years.
Precancerous lesions are those which are generally confined to the lining or surface of an organ. The changes in cells make them into cancer cells with the potential to develop into full blown cancer at some point. Cancer has the potential to spread to distant sites.
At present there is no way to predict if and when the precancerous lesions turn to cancer. Many never progress. Ideally such lesions are best taken out. Your gynecologist and oncologist will have more information after the repat biopsy.