Female Repro: 13.1: Vulva 13.2: Vagina

Question 1

What kind of cell lines the external female genitalia?

Answer 1

squamous epi

Question 2

What causes a condyloma?

Answer 2

HPV 6 or 11

Question 3

What characterizes a condyloma?

Answer 3

koilocytic change

Question 4

What is koilocytic change on histology?

Answer 4

a crinkled, raisin-looking nucleus

Question 5

What kind of genetic material does HPV have?

Answer 5

DNA

Question 6

Name the high risk HPV serotypes.

Answer 6

16, 18, 31, 33

Question 7

What is lichen sclerosis?

Answer 7

thinning of the epidermis and fibrosis of the dermis

Question 8

“Leukoplakia with parchment-like vulvar skin”

Answer 8

lichen sclerosis

Question 9

Who gets lichen sclerosis? What is the prognosis?

Answer 9

postmenopausal women; it’s benign but can be assoc. with squamous cell CA

Question 10

What is lichen simplex chronicus?

Answer 10

hyperplasia of vulvar squamous epi

Question 11

What is the difference btw lichen sclerosis and lichen simplex chronicus?

Answer 11

lichen simplex chronicus = thickened from chronic irritation; NO risk of SCC.

lichen sclerosis = thin epidermis from atrophy; risk of SCC

Question 12

What causes lichen simplex chronicus?

Answer 12

chronic irritation and scratching

Question 13

What is the prognosis for lichen simplex chronicus?

Answer 13

benign; NO risk of SCC

Question 14

From what cell does vulvar carcinoma arise?

Answer 14

squamous epithelium

Question 15

Name the 2 pathways that vulvar carcinoma can be initiated from.

Answer 15

1. HPV –> vulvar intraepithelial neoplasia

2. non-HPV related from long-standing lichen sclerosis (women > 70yo)

Question 16

What is extramammary Paget disease?

Answer 16

malignant epi cell in the epidermis of the vulva

Question 17

How does extramammary Paget disease present?

Answer 17

itchy, red, ulcerated skin

Question 18

What are the path staining findings in extramammary Paget disease?

Answer 18

PAS +, keratin +, and S100-

Question 19

What are the path staining findings in melanoma?

Answer 19

PAS-, keratin-, and S100+

Question 20

What is the intermediate filament in epi cells?

Answer 20

keratin

Question 21

Keratin+ in malignancy = ?

Answer 21

carcinoma

Question 22

S100+ in malignancy = ?

Answer 22

melanoma

Question 23

If a malignancy is producing mucous (PAS+), it must be ____.

Answer 23

carcinoma

Question 24

What kind of cell lines the vagina?

Answer 24

squamous epi

Question 25

What is vaginal adenosis?

Answer 25

focal persistence of columnar epi in the upper 1/3 of the vagina

Question 26

What increases the risk of vaginal adenosis?

Answer 26

DES exposure in utero

Question 27

The lower 2/3 of the vaginal is derived from the ____.

Answer 27

urogenital sinus

Question 28

The upper 1/3 of the vagina is derived from the ____.

Answer 28

Mullerian duct

Question 29

Adenosis increases the risk of _____.

Answer 29

clear cell adenocarcinoma

Question 30

What is clear cell adenocarcinoma?

Answer 30

malignant proliferation of glands with clear cytoplasm

Question 31

What is an embryonal rhabdomyosarcoma?

Answer 31

malignant mesenchymal proliferation of immature skeletal muscle in the vagina

Question 32

How does an embryonal rhabdomyosarcoma present?

Answer 32

a grape-like mass protruding from the vagina or penis of a child

Question 33

PAS +, keratin +, and S100-

Answer 33

extramammary Paget disease

Question 34

This is a malignant proliferation of glands with clear cytoplasm in the vagina.

Answer 34

clear cell adenocarcinoma

Question 35

This is a malignant mesenchymal proliferation of immature skeletal muscle in the vagina or penis.

Answer 35

embryonal rhabdomyosarcoma

Question 36

What are the path. findings in a rhabdomyoblast?

Answer 36

cytoplasmic cross-striations with positive IHC staining for desmin and myoglobin

Question 37

This is a grape-like mass protruding from the vagina or penis of a child.

Answer 37

embryonal rhabdomyosarcoma

Question 38

Where is desmin found?

Answer 38

in skeletal muscle

Question 39

What causes vaginal carcinoma?

Answer 39

high risk HPV

Question 40

Dx given these path findings? cytoplasmic cross-striations with positive IHC staining for desmin and myoglobin

Answer 40

rhabdomyoblast (embryonal rhabdomyosarcoma)

Question 41

What is vaginal carcinoma?

Answer 41

carcinoma of the squamous epi lining the vagina

Question 42

What is the precursor lesion for vaginal carcinoma?

Answer 42

vaginal intraepithelial neoplasia (VAIN)

Question 43

Cancer from the lower 2/3 of the vagina goes to the ____ lymph nodes.

Answer 43

inguinal

Question 44

Cancer from the upper 1/3 of the vagina goes to the ____ lymph nodes.

Answer 44

regional iliac