女阴鲍温病样丘疹病6例临床病理观察

Bowenoid papulosis of vulva: a clinicopathological analysis of 6 cases

目的 探讨鲍温病样丘疹病的临床病理特点、诊断要点和鉴别诊断。方法 收集 6例鲍温病样丘疹病病例 ,分析总结临床病史、病变特点及免疫组化检测HPV ,并复习相关文献 ,对 5例进行了 1～ 6年随访。结果 鲍温病样丘疹病是多发于年轻女性的良性病变 ,病理学检查发现鳞状上皮增生明显 ,伴轻、中度异型 ,多见核分裂象 ,一般不累及毛囊和皮脂腺。结论 诊断鲍温病样丘疹病时要临床、病理相结合 ,应与尖锐湿疣、鲍温病及假性温疣进行鉴别。

Objective To investigate the clinicopathological characteristics and difference of Bowenoid papulosis (BP) from other diseases in the vulva. Methods Six cases of BP were studied clinicopathologically and the pathogen of HPV16 was detected in the tissues by immunostaining together with review of literature.The clinicopathologic characteristics of the disease and its differential diagnosis were analyzed and discussed. Five cases were followed up. Results BP had typical morphological characteristics grossly and was similar to Bowen's disease histologically, which showed mild to florid hyperplasia of the cells in the spinosum layer with easily seen mitoses, in which chromosome were arranged along the equator plate.The disease did not affect hair follicle and sebaceous gland. A good prognosis was observed after 1～6 years follow-up and the disease was regressed spontancously. Conclusion The presence of mild to severe cytological atypia is a feature of BP. The diagnosis should be made by combination of clinical manifestations with pathology, and excluding Bowen's disease, condyloma acuminata and pseudocondyloma.