47-year-old female with multiple papillary vulvar lesions.

Procedure: Excisional biopsies.

Gross: he specimen consists of 3 pink polypoid lesion measuring 0.7 to 1.7 cm. in greatest dimension. The specimen is sectioned. All submitted.

Micro: Sections show papillary squamous lesion with parakeratosis and areas of acanthosis. The complex squamous papillae are lined by well differentiated squamous cells with intact basement membrane. Fibrovascular cores are present in the stalk of the papillae. HPV infected koilocytic cells are noted with enlarged resinoid irregular nuclei and clear cytoplasm. There is no evidence of high grade squamous intraepithelial lesion (SIL), vulvar intraepithelial neoplasm (VIN) or invasive squamous cell carcinoma. H & E stain