Pathology of Cervix, Vagina, and Vulva 4 Flashcards

Describe the two pathways of squamous carcinogenesis in the vulva 1) HPV related, 2) related to lichen sclerosus.

1
Q

What is the pathway of squamous carcinogenesis in the vulvula related to HPV?

A
  • Induced by low risk HPV infections
  • Called condylomas - exophytic proliferations of squamous cells
  • More likely in immunocompromised people
  • Lesions not considered premalignant due to low risk HPV as the causative agents
  • More common in younger women
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2
Q

What are pathologic hallmarks of a condyloma?

A
  • Papillae
    • finger-like projections of epithelium with fibrovascular cores
  • Eptiehalial thickening - acanthosis
  • Koilocytic change
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3
Q

What is the pathway of squamous carcinogenesis in the vulva related to lichen sclerosus?

A
  • Etiology is not entirely understood
  • Thought to be related to lack of estrogen and autoimmunity
  • Progressive condition - precursor to some cases of vulvar squamous cell carcinoma
  • “Differentiated” VIN pathway
    • associated with p53 mutations
    • lichen sclerosis in 70%
    • older women
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