Fig. 1. Flat condyloma acuminatum/vulvar intraepithelial neoplasia (VIN) 1. There is lack of maturation in the lower one third of the epithelium and maturation with koilocytosis in the upper epithelium. Volume 4, Chapter 40

Fig. 2. Vulvar intraepithelial neoplasia (VIN) 3, multifocal. Note raised pale lesions on outer minora and across fourchette. Volume 4, Chapter 40

Fig. 3. Vulvar intraepithelial neoplasia (VIN) 3 (severe dysplasia), basaloid type. This intraepithelial lesion is composed of relatively uniform epithelial cells with little maturation and nuclear hyperchromasia. Volume 4, Chapter 40

Fig. 4. Vulvar intraepithelial neoplasia (VIN) 3 (severe dysplasia/carcinoma in situ ), warty type. Atypical cells extend throughout the full thickness of the epithelium. There is nuclear pleomorphism with koilocytes near the surface. Volume 4, Chapter 40

Fig. 1. VIN III. Note large irregular nuclei, loss of differentiation, and overlying hyperkeratosis (black arrow). Volume 4, Chapter 42

Fig. 5. Primary Paget disease (type 1). Note irregular patchy change present on lateral aspect of labium majus. Volume 4, Chapter 40

Fig. 6. Primary Paget disease (type 1). Characteristic large, pale Paget cells are just above basal layer (magnification, ×500). Volume 4, Chapter 40

Fig. 7. Type 3 Paget disease of the vulva (pagetoid urothelial intraepithelial neoplasia [PUIN]). The vulvar epithelium is infiltrated by clusters of high-grade urothelial carcinoma. The nuclei are hyperchromatic with irregular contours. Volume 4, Chapter 40

Fig. 1. Locally extensive vulvar cancer arising from the posterior lateral vulva ( A) and extending onto the buttocks ( B ). Such cases are commonly associated with profound denial and embarrassment and are generally not resectable primarily. Volume 4, Chapter 43

Fig. 2. Patient with vulvar cancer after 4 weeks ( A) and 6 weeks ( B) of chemoradiation. Extensive tumor resolution is observed and extensive skin reaction demonstrated. Further therapy by posterior exenteration offered local control. Volume 4, Chapter 43

Fig. 8. Superficially invasive squamous cell carcinoma with vulvar intraepithelial neoplasia (VIN) 3. There is a marked inflammatory response.

Fig. 10. Well-differentiated squamous carcinoma. Large cells with abundant cytoplasm form keratin pearls (magnification, ×80).

Fig. 11. Poorly differentiated squamous cell carcinoma of the vulva. The tumor cells are nonkeratinized, without prominent intercellular bridges. The tumor has a “finger-like” pattern of invasion.

Fig. 12. Adenoid-squamous pattern with pseudoglandular spaces lined by squamous cells (magnification, ×500).

Fig. 13. Squamous cell carcinoma, warty or condylomatous type. The epithelium shows little cellular atypia and the tumor-dermal interface is infiltrative rather than pushing in appearance.

Fig. 14. Basal cell carcinoma. The tumor is composed of small, uniform hyperchromatic cells with peripheral palisading of the nuclei. Central necrosis is present focally.

Fig. 15. Malignant melanoma. Large nevoid cells with prominent nucleoli extend down from dermoepidermal junction. Some contain pigment (magnification, ×400).

Fig. 16. Leiomyosarcoma of the vulva. The tumor is composed of fascicles of smooth muscle with nuclear atypia, characterized by enlarged, irregular, and hyperchromatic nuclei.

Fig. 17. Fibrous histiocytoma. Spindle-shaped cells with elongated nuclei form swirling patterns (magnification, ×400).

Fig. 5. Carcinoma in situ showing epithelial atypia throughout the epithelial layer. Volume 1, Chapter 9

Fig. 7. Hidradenoma of the vulva ( × 25) Volume 1, Chapter 9

Fig. 8 . Syringoma Numerous dilated sweat gland ducts are seen ( × 35). Volume 1, Chapter 9

Fig. 9. Intradermal nevus. Nevus cells are seen in the upper dermis ( × 40) Volume 1, Chapter 9

Fig. 10. Junctional nevus. This type may become malignant ( × 50) Volume 1, Chapter 9

Fig. 11. Compound nevus. Nevus cells are seen at the junction of the epidermis and dermis and in the upper dermis (× 50)  Volume 1, Chapter 9

Fig. 13. Fibroma. Coarse bundles of fibroblasts and fibrocytes are seen ( × 65) Volume 1, Chapter 9.

Fig. 14. Neurofibroma. Spindle cells with angulated nuclei are seen ( × 50) Volume 1, Chapter 9.

Fig. 15. Granular cell tumor ( × 70) Volume 1, Chapter 9.

Fig. 16. Lymphangioma with many dilated lymphatic channels ( × 90) Volume 1, Chapter 9.