WOMENS-HEALTH Messages for July, 2008: ONCOLOGY: VIN 2 Differentiated

ONCOLOGY: VIN 2 Differentiated - Biopsy Pathology Report

From: Mom (anonymous@obgyn.net)
Sun, 27 Jul 2008 10:11:52 -0500 (CDT)

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My daughter is a sexually active 20 year old college student (she's leaving the initial research on this up to me- probably better with all the possibilities you see on the internet). For at least the past 5 years she has had almost chronic issues with vulvar itching. She has been on many creams for Yeast Infections as well as about 10 cases of Bacterial Vaginosis (maybe more since she has to travel home from college to get to our GYN which doesn't always happen). Last year our OBGYN finally sent her to a GYN Specialist, at the time she finally got in for her appointment he told her she didn't have BV right then and come back when she did. She had an episode of bloody diarrhea this past winter and after a clear upper GI scan, and colonoscopy in January they found a clear polyp and an adenomas nodule (precancerous) which were removed. She also has been having urinary issues (urge to go) so our GP sent her to a Urologist and she's currently taking Detrol.

After continued itching/burning/pain issues I insisted on another appointment with the GYN Specialist this January and we saw his associate. He diagnosed her with Vulvar Vestibulitis and gave her Lidocaine to numb the area, incidentally he suggested she start Gardisil shots, which she's now completed. A few weeks ago she was back to our GYN and she pointed out a few (3-4) "bumps under the skin- haired area, both sides". They biopsied one bump. The biopsy came back with VIN 2, and I've scheduled her to see another Specialist at the same Hospital in mid-August (I'm told this one has experience with Oncology and knows about VIN). The GYN told me they would probably laser the bumps off. BTW she had a negative PAP last summer and tells me she's had recent HIV/STD screening, all negative.

I'm a Mom who WANTS to know as much as possible before we go in. I've got a copy of the Pathology report now and after doing 2 days of research online I still have some questions.

FINAL PATHOLOGY: Focal Vulvar Intraepithelial Neoplasia (VIN 2), Differentiated Type. Epidermal Cyst. Ki-67: Positive Staining into Parakeratotic Layer. P-16: Positive Patch Cytoplasmic and Nuclear Staining. The detail says the epidermal cyst-benign, underlying the dysplastic epithelium is negative for p16. It mentions a rare mitotic figure in the middle third of the epidermis, as well as the P-16 and few koilocytic cells support a high-risk HPV infection. Findings consistent with a localized high grade squamous intraepithelial lesion or VIN 2. ***Too long, See "My Questions" below (first post, hoping I can add):

--
Concerned Mom (and Dad)

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