In this section we have spot diagnoses posted on a daily basis since June 2010, now over 1700! You can review the archived cases and read the suggested diagnoses by users and the final comment by Dr Uma Sundram, the Editor-in-Chief and main spot diagnosis host. Case are uploaded each week day by 10 a.m. UK time with the correct diagnosis will generally be posted at 8 p.m. UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 1397- 30 October Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
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Case History: Papillomatous lesions in vulval vestibule.

Case posted by Dr Richard Carr


User Feedback


Dr. Mona Abdel-Halim

Posted

LSIL, I don't think there is actual invasion. any P16, P53 or Ki67?

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Guest Romualdo

Posted

Vestibular papillomatosis. I think there are no cytopathic changes of HPV infection.

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Arti Bakshi

Posted

I think Romualdo is right!! (yet again).
Never heard of vestibular papillomatosis before (is there any end to the entities in dermpath!?!), but the histology would fit. Apparently this is a normal anatomic variation of vulval vestibule!
I don't think there is dysplasia or genuine koilocytic change, the latter excludes viral wart (which is the main differential diagnosis).

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Dr. Mona Abdel-Halim

Posted

I thought of vestibular papillomatosis also Romualdo but favoured LSIL as I perceived actual increase in the proliferative compartment (expansion of immature basal cells) (reduced maturation in the lower third)? I think a Ki67 will help.

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Dr. Richard Carr

Posted

Well I agree there are an endless number of entities and I had not heard of this one either but fortunately the clinician had!! I reported it as in keeping with clinical diagnosis of vestibular papillomatosis. Well done Romualdo - again! I don't think I did any immunostains.

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