Female reproductive system- Vulva, Vagina, Cervix Flashcards
Viruses causing Vulvitis
1) HPV
2) HSV-1, HSV-2
Fungus causing Vulvitis
Candida Albicans
Bacteria causing Vulvitis
Neisseria Gonorrhoea
Parasit causing Vulvitis
Trichomonas Vaginalis
Complication of Vulvitis
Bartholin Gland Cyst
Cause of Bartholin Gland Cyst
Obstruction of the excretory ducts of Bartholin glands
Clinical presentation of Bartholin Gland Cyst
painful dilation of the glands
(Bartholin Cyst) and abscess formation
Microscopic findings:
– Most common lining: Transitional-type epithelium
– However, cuboid, columnar, ciliated, and squamous
cells may be also observed
– The cyst wall contains a variable number of chronic inflammatory cells and normal or atrophic acini
Macroscopic findings:
- Unilocular cyst filled with serous fluid
features of?
Bartholin Gland Cyst
patho of Lichen Scleroscus
Presence of activated T-cells in the subepithelial inflammatory infiltrate and the increased frequency of autoimmune disorders suggest an
autoimmune aetiology
Epi of Lichen Sclerosus
post-menopausal women
Clinical presentation of Lichen Sclerosus
White plaques (leukoplakia) or
papules
Microscopic findings:
1. Thinning of the epidermis
2. Disappearance of rete pegs
3. Hydropic degeneration of the basal cells
4. Dermal fibrosis
5. Scant perivascular mononuclear inflammatory cell
infiltrate
features of?
Lichen Sclerosus
DD of Lichen Sclerosus
Other causes of leukoplakia, such as Psoriasis, Lichen Planus and Squamous Cell Carcinoma (in situ or invasive)
Progression & Prognosis of Lichen Sclerosus
Benign, but slightly increased (1-5%) risk of SCC
patho of Lichen Simplex Chronicus
autoimmune aetiology
Clinical presentation of Lichen Simplex Chronicus
White plaques (leukoplakia) or
papules
Microscopic findings:
1. Epithelial thickening (particularly of the stratum granulosum)
2. Hyperkeratosis (thickening of the startum corneum, outer layer of skin)
3. Increased mitotic activity in the basal and suprabasal layers
4. No epithelial atypia
5. Leukocytic infiltration of the dermis
features of ?
Lichen Simplex Chronicus
DD of Lichen Simplex Chronicus:
Other causes of leukoplakia, such as Psoriasis, Lichen Planus and Squamous Cell Carcinoma (in situ or invasive)
progression & prognosis of Lichen Simplex Chronicus
Benign, isolated lesions, that do not have a risk of developing SCC
Which has a risk of developing SCC, Lichen Simplex Chronicus/ Lichen Sclerosus
Lichen sclerosus
Epi of Condylomata lata
- Rare, Benign lesions
- Manifestation of Secondary Syphilis
Macroscopic picture: Flat, moist, minimally elevated lesions
features of?
Condylomata Lata
Cause of Condylomata Acuminata
HPV infection (subtypes 6 and 11)
Clinical presentation of Condylomata Acuminata
Condyloma - Papillary and distinctly elevated or somewhat flat lesions
Microscopic findings:
* Epithelial hyperplasia and
* presence of epithelial cells with peri-nuclear
cytoplasmic vacuolisation and wrinkled nuclear
contours (koilocytosis)
features of?
Condylomata Acuminata
Epi of Valvular Carcinoma
- 3% of all female genital tract cancers (rare)
- women > 60yrs
Clinical presentation of Valvular CA?
– Areas of leukoplakia (especially in cases of in situ or early invasive carcinomas)
– Exophytic or ulcerated tumours (especially in cases of infiltrating carcinomas
Which form of Valvular SCC is associated w/ HPV infection and Valvular Intraepithelial Neoplasia (VIN)?
The Less common From
(More common form is no ass/ with HPV and VIN)
Epi of the Less common from of valvular SCC
Middle-aged women
Which from of Valvular SCC has the following Microscopic features -> Poorly differentiated Squamous Cell Carcinomas
Less common form
Which form of Valvular SCC has the following Micro features –> Well-differentiated keratinising
Squamous Cell Carcinomas
Common form
Epi of the More common form of Valvular SCC
Older women
Cause of Valvular Extra-Mammary Pagest Disease
not ass. w/ an underlying carcinoma, unlike paget disease of the breast
Clinical presentation of Valvular Extra-Mammary Paget Disease
Red, scaly, crusted plaque and Erythema
Microscopic findings:
- Infiltration of the epidermis, singly and in nests of neoplastic cells
- Pleomorphic Nuclei w/ vesicular chromatin
features of?
Valvular Extra-Mammary Paget Disease
DD of Valvular Extra-Mammary Paget Disease
Vulvar Melanoma
Congenital Vaginal Abnormalities
1) Absence of the vagina
2) Septate or double vagina (usually associated with a septate cervix and, sometimes, septate uterus)
3) Congenital, lateral Gartner Duct Cysts, arising from persistent Wolffian duct rests (Gartner’s Ducts = Mesonephric Ducts or Wolffian Ducts)
Epi do Vaginitis
Common
Cause of Vaginits
- Fungus: Candida Albicans
- Parasites: Trichomonas vaginalis
- Bacteria: Neisseria gonorrhoeae
Risk factors of Vaginitis
1) DM,
2) systemic antibiotic therapy (which causes
disruption of normal microbial flora),
3) immunodeficiency,
4) pregnancy, or recent abortion
Clinical presentation of Vaginitis
Vaginal discharge (leukorrhoea)
Clinical presentation of Vaginitis caused by Candida Albicans vs Trichomonas Vaginalis
- Candida albicans –> Curdy, white discharge
- Trichomonas vaginalis -> Watery, copious gray-green discharge
Epi of Valvular SCC
Rare, women > 60yrs
VAginal Intraepithelial Neoplasia (VAIN) is a precursor
lesion that is nearly always associated with?
HPV infection (subtypes 16 and 18)
Clinical presentation of Valvular SCC
1) Areas of leukoplakia (especially in cases of in situ or
early invasive carcinomas)
2) Exophytic or ulcerated tumours (especially in cases
of infiltrating carcinomas)
Epi of Valvular Clear Cell Adenocarcinomas
Very rare, In young women whose mothers took diethylstilbestrol during pregnancy (to prevent threatened abortion)
precursor of Valvular Clear Cell Adenocarcinomas
Vaginal Adenosis
Embryonal Rhabdomyosarcoma are aka?
Sarcoma Botryoides
Epi of Sarcoma Botryoides
Most common soft tissue sarcoma of
childhood and adolescence (girls <4yrs)
Clinical presentation of Sarcoma Botryoides
Soft, gelatinous, grape-like mass
Microscopic findings:
- Rhabdomyoblast (Granular eosinophilic cytoplasm, rich in thick and thin filaments)
Macroscopic features:
- Polypoid, grape-like soft tissue
features of?
Sarcoma Botryoides - Embryonal Rhabdomyosarcoma
Microscopic features:
- Hobnail-shaped cells
- Dark, atypical nuclei
- Tubules, ductules, and cystic spaces
features of?
Valvular Clear Cell Adenocarcinomas
