021815 path vulva

Question 1

what are non-neoplastic epithelial lesions of vulva?

Answer 1

lichen sclerosus (increased risk of SCC)
lichen simplex chronicus

Question 2

neoplastic lesions of vulva

Answer 2

squamous dysplasia (condyloma, VIN)

carcinoma of vulva (sq cell, adeno, basal cell, melanoma)

paget disease

mesenchymal lesions

Question 3

lichen sclerosus is seen commonly in what age group

Answer 3

premenarchal or postmenopausal

Question 4

symptoms of lichen sclerosus

Answer 4

painful, pruritic
thin epidermis (shiny)
leukoplakia

Question 5

histology of lichen sclerosus

Answer 5

thin epidermis

fibrotic dermis, chronic inflam cell infiltrate

Question 6

lichen simplex chronicus develops secondary to

Answer 6

chronic irritation underlying inflammatory dermatosis

Question 7

histology of lichen simplex chronicus

Answer 7

epithelial thickening
hyperkeratosis
dermal chronic inflam

Question 8

condyloma accuminata in vulva

Answer 8

VIN-1 (warty lesion)

Question 9

high grade vulvar intraepithelial neoplasia

Answer 9

VIN2, VIN3

HPV associated-16,18

Question 10

histology for vulvar dysplasia

Answer 10

in full thickness dysplasia: nuclear atypia, high nuclear to cyto ratio, abundant mitosis

Question 11

types of vulva carcinoma

Answer 11

90% is sq cell carcinoma
adenocarcinoma, basal cell, malignant melanoma

two distinct forms: high risk HPV associated (preceded by VIN), older age group (preceded by reactive changes like lichen sclerosis)

Question 12

extramammary Paget’s dis

Answer 12

red scaly plaques
intraepidermal prolif or malignant cells
large pale cells in epidermis (glandular)