Female Repro: 13.1: Vulva 13.2: Vagina Flashcards
What kind of cell lines the external female genitalia?
squamous epi
What causes a condyloma?
HPV 6 or 11
What characterizes a condyloma?
koilocytic change
What is koilocytic change on histology?
a crinkled, raisin-looking nucleus
What kind of genetic material does HPV have?
DNA
Name the high risk HPV serotypes.
16, 18, 31, 33
What is lichen sclerosis?
thinning of the epidermis and fibrosis of the dermis
“Leukoplakia with parchment-like vulvar skin”
lichen sclerosis
Who gets lichen sclerosis? What is the prognosis?
postmenopausal women; it’s benign but can be assoc. with squamous cell CA
What is lichen simplex chronicus?
hyperplasia of vulvar squamous epi
What is the difference btw lichen sclerosis and lichen simplex chronicus?
lichen simplex chronicus = thickened from chronic irritation; NO risk of SCC.
lichen sclerosis = thin epidermis from atrophy; risk of SCC
What causes lichen simplex chronicus?
chronic irritation and scratching
What is the prognosis for lichen simplex chronicus?
benign; NO risk of SCC
From what cell does vulvar carcinoma arise?
squamous epithelium
Name the 2 pathways that vulvar carcinoma can be initiated from.
- HPV –> vulvar intraepithelial neoplasia
2. non-HPV related from long-standing lichen sclerosis (women > 70yo)
What is extramammary Paget disease?
malignant epi cell in the epidermis of the vulva
How does extramammary Paget disease present?
itchy, red, ulcerated skin
What are the path staining findings in extramammary Paget disease?
PAS +, keratin +, and S100-
What are the path staining findings in melanoma?
PAS-, keratin-, and S100+
What is the intermediate filament in epi cells?
keratin
Keratin+ in malignancy = ?
carcinoma
S100+ in malignancy = ?
melanoma
If a malignancy is producing mucous (PAS+), it must be ____.
carcinoma
What kind of cell lines the vagina?
squamous epi
What is vaginal adenosis?
focal persistence of columnar epi in the upper 1/3 of the vagina
What increases the risk of vaginal adenosis?
DES exposure in utero
The lower 2/3 of the vaginal is derived from the ____.
urogenital sinus
The upper 1/3 of the vagina is derived from the ____.
Mullerian duct
Adenosis increases the risk of _____.
clear cell adenocarcinoma
What is clear cell adenocarcinoma?
malignant proliferation of glands with clear cytoplasm
What is an embryonal rhabdomyosarcoma?
malignant mesenchymal proliferation of immature skeletal muscle in the vagina
How does an embryonal rhabdomyosarcoma present?
a grape-like mass protruding from the vagina or penis of a child
PAS +, keratin +, and S100-
extramammary Paget disease
This is a malignant proliferation of glands with clear cytoplasm in the vagina.
clear cell adenocarcinoma
This is a malignant mesenchymal proliferation of immature skeletal muscle in the vagina or penis.
embryonal rhabdomyosarcoma
What are the path. findings in a rhabdomyoblast?
cytoplasmic cross-striations with positive IHC staining for desmin and myoglobin
This is a grape-like mass protruding from the vagina or penis of a child.
embryonal rhabdomyosarcoma
Where is desmin found?
in skeletal muscle
What causes vaginal carcinoma?
high risk HPV
Dx given these path findings? cytoplasmic cross-striations with positive IHC staining for desmin and myoglobin
rhabdomyoblast (embryonal rhabdomyosarcoma)
What is vaginal carcinoma?
carcinoma of the squamous epi lining the vagina
What is the precursor lesion for vaginal carcinoma?
vaginal intraepithelial neoplasia (VAIN)
Cancer from the lower 2/3 of the vagina goes to the ____ lymph nodes.
inguinal
Cancer from the upper 1/3 of the vagina goes to the ____ lymph nodes.
regional iliac
