A case of high-grade vulvar dysplasia with underlying spherules of amyloid deposition

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. \nCase 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. \nConclusion: 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.