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PinD48.5

Author:Prof. Dr. med. Peter Altmeyer

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Last updated on: 27.04.2025

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Synonym(s)

penile intraepithelial neoplasia

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DefinitionThis section has been translated automatically.

Acronym for non-invasive "penile intraepithelial neoplasia" (carcinoma in situ) in the area of the penis (glans penis, inner preputial leaf, penile shaft).

ClassificationThis section has been translated automatically.

The acronym includes 3 malignant, pre-invasive, epithelial entities of the penis, which are summarized under this term: It is now increasingly common to speak of penile intraepithelial neoplasia.

EtiopathogenesisThis section has been translated automatically.

Most detected cases are HPV infections, with "high-risk-alpha HPV types" dominating HPV 16 and 18. Low-risk HPV types (HPV 6 and 11) are only found in PINs with low dysplasia. Predisposing are HIV infection, genital lichen sclerosus et atrophicus, lichen planus, lack of genital hygiene, smoking.

ManifestationThis section has been translated automatically.

Pat. with erythroplasia Queyrat and penile M. Bowen are usually affected after the 50th LJ. Patients with bowenoid papulosis usually develop the disease between 28-35 years of age.

HistologyThis section has been translated automatically.

Histopathological classification:

PIN is divided into three grades of severity according to the vertical extent of the dysplastic cell changes within the epidermis:

  • PIN 1- Lower third of the epidermis - low-grade squamous intraepithelial lesion (LSIL)
  • PIN 2- Lower two-thirds of the epidermis- High-grade squamous intraepithelial lesion (HSIL)
  • PIN 3- Complete epidermal width- Carcinoma in situ

Histologic subtypes:

  • Differentiated PIN- acanthosis, parakeratosis, large keratinocytes with abundant eosinophilic cytoplasm, atypical basal cells with hyperchromasia
  • Basaloid PIN- Monomorphic, small, basophilic cells permeate the entire epidermis
  • Warty PIN- Papillomatous surface, pronounced atypical parakeratosis, pleomorphic koilocytes

Warty-basaloid PIN- Combined features of both aforementioned subtypes

TherapyThis section has been translated automatically.

Excision of the affected area, electrocausal ablation, laser ablation, topical therapy with 5-FU or Imiquimod.

Progression/forecastThis section has been translated automatically.

While erythroplasia and Bowen's disease of the penis almost never show spontaneous remission and in the long run turn into a penis carcinoma, Bowenoid papulosis often shows spontaneous remission with complete healing.

LiteratureThis section has been translated automatically.

  1. Kreuter A et al (2008) Penile intraepithelial neoplasia is frequent in HIV-positive men with anal dysplasia. J Invest Dermatol (2008) Epub ahead of print
  2. Porter WM et al (2002) Penile intraepithelial neoplasia: clinical spectrum and treatment of 35 cases. Br J Dermatol 147: 1159-1165

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Last updated on: 27.04.2025

Author: Prof. Dr. med. Peter Altmeyer