Female Genital Pathology III

Question 1

patterns of invasive SCC of vulva

Answer 1

60% - SCC, warty and bowenoid type (HPV) - repro age women

40% - SCC keratinizing type (no HPV) - elderly women 70yo

Question 2

keratinizing SCC of vulva

Answer 2

no HPV

elderly women

Question 3

warty SCC of vulva

Answer 3

yes HPV

women repro age

Question 4

tx of SCC of vulva

Answer 4

vulvectomy and lymphadenectomy

Question 5

prognosis - SCC of vulva

Answer 5

depends on stage

low - <1mm invasion - 80% 5 year

high - tumor invades sidewall, mets - 10% 5 year

Question 6

keratin pearls

Answer 6

SCC - of vulva

Question 7

any ulcerated lesion of vulva

Answer 7

needs biopsy

Question 8

accesory breast tissue

Answer 8

along milk line
-extends into vulva

rarely - primary site of adenocarcinoma

Question 9

sharply circumscribed nodule in vulva with normal overlying skin

Answer 9

papillary hidradenoma
-b9

double layer cells - columnar myoepithelial

Question 10

paget disease

Answer 10

extramammary - malignant

itchy, red, crusty, sharply demarcated area on labia majora
-elderly women

Question 11

cells of paget

Answer 11

germinal cells of mammary gland ducts in vulvar skin

Question 12

halo cells

Answer 12

paget cells

Question 13

PAS positive, mucin positive
CEA positive, EMA positive
S-100 negative, melanin-A negative

Answer 13

extramammary pagets

low potential for mets

Question 14

tx of pagets

Answer 14

wide local excision

Question 15

malignant melanoma

Answer 15

of vulva
-poor prognosis - usually nodular

S100 and melanin A positive

Question 16

S100 positive

melanin A positive

Answer 16

malignant melanoma

Question 17

pigmented lesion of vulva

Answer 17

needs to be biopsied**

melanosis - b9 pigmentation vs. melanoma - indistinguishable looking alone

Question 18

most vaginal neoplasms

Answer 18

80% mets from cervix
SCC are most common primary cancer

arise from premalignant VaIN

HPV - esp 16

Question 19

embryonal rhabdomyosarcoma

Answer 19

girls <3cm

lamina propria of vaginal wall

presentation - vaginal bleeding

Question 20

cysts of lateral vaginal wall

Answer 20

gartner duct
-wolffian remnant

simple cyst with monolayer of b9 cuboidal epithelium

Question 21

tx of gartner duct cyst

Answer 21

excisional bx

Question 22

vaginal adenosis

Answer 22

normally - glandular epithelium - replaced by squamous epithelium - by 18 weeks

vaginal adenosis -doesn’t occur

occured with DES use for miscarriages

Question 23

DES

Answer 23

lead to vaginal adenosis

some affected daughters - clear cell carcinoma of vagina**

Question 24

women with DES exposure in utero

Answer 24

increased risk of CIN and VIN

Question 25

velvety red area on vaginal mucosa

Answer 25

vaginal adenosis

presence of glandular tissue in vagina - abnormal

Question 26

grape like tumor

Answer 26

embryonal rhabdomyosarcoma

Question 27

DES

Answer 27

adenosis > clear cell carcinoma