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Case Report
A case of high-grade vulvar dysplasia with underlying spherules of amyloid deposition
1 Department of Pathology and Laboratory Medicine, Pennsylvania Hospital of the University of Pennsylvania Health System, 801 Spruce Street, 10th Floor Spruce Building, Philadelphia, Pennsylvania 19107, USA
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Christopher P Julien
Department of Pathology and Laboratory Medicine, Pennsylvania Hospital of the University of Pennsylvania Health System, 801 Spruce Street, 10th Floor Spruce Building, Philadelphia, Pennsylvania 19107,
USA
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Article ID: 101059Z01CJ2019
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Julien CP, Ekedaus J, Lamzabi I. A case of highgrade vulvar dysplasia with underlying spherules of amyloid deposition. Int J Case Rep Images 2019;10:101059Z01CJ2019.ABSTRACT
Introduction: High-grade vulvar intraepithelial neoplasia (VIN3) is a common pathologic diagnosis. Usually, the lesions are associated with human papillomavirus (HPV), as demonstrated by block positivity on p16 staining. The lesions are not typically associated with amyloid deposition. It is even more rare to find amyloid spherules associated with high-grade vulvar dysplasia. The clinicopathologic significance of the amyloid spherules is unclear.
Case Report: In this article, we discuss a case of a 59-year-old female with VIN3-associated underlying amyloid spherules that are present primarily only where there is high-grade dysplasia, and absent in other portions of the specimen. The patient of our study did not have a history of amyloidosis, and the lesion represented the only area of known amyloid deposition in this patient.
Conclusion: These findings support the association between amyloid deposition and HPV-related cases of high-grade VIN. We postulate that the presence of high-grade dysplasia was the causative factor of the amyloid deposition in this case.
Keywords: Amyloid, Congo red, High-grade squamous intraepithelial neoplasia, Highgrade vulvar intraepithelial neoplasia, Human papillomavirus, Localized cutaneous amyloidosis, Spherule, VIN3, Vulvar dysplasia
SUPPORTING INFORMATION
Author Contributions
Christopher P Julien - Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Final approval of the version to be published
John Ekledaus - Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Ihab Lamzabi - Substantial contributions to conception and design, Analysis of data, Interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe guarantor of submission is Ihab Lamzabi, MD.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2019 Christopher P Julien et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
