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
2
Q
What are pathologic hallmarks of a condyloma?
A
-
Papillae
- finger-like projections of epithelium with fibrovascular cores
- Eptiehalial thickening - acanthosis
- Koilocytic change
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