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Pathology for Urologists

Bowenoid Papulosis


Image A
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Image B
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  • Clinical: multiple papules in anogenital region of young men that histologically resemble squamous cell carcinoma in situ.
  • Most often related to HPV 16.
  • Usually transmitted sexually.
  • Younger patients than PEIN (30's to 40's).
  • Gross: usually occur on penile shaft; papules range from 0.2 to 1.0 cm; sometimes coalesce to form plaques like condyloma acuminatum.
  • Histology:
  • Proliferation of atypical basaloid cells and koilocytic change can be seen (image A) & (image B). (Resemble HPV-related PEIN).
    • May involve sweat gland (unlike PEIN).
    • Usually spare the pilosebaceous units (unlike PEIN).
  • Most have benign course and may undergo spontaneous regression.
  • Minority may progress to SCC; but mainly considered not precancerous.

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