Pathoma: Vagina

Question 1

What type of epithelium lines the vagina?

Answer 1

Stratified squamous epithelium

Question 2

What is adenosis?

Answer 2

In normal embryologic development, the upper 2/3 of the vagina are columnar epithelium (derived from the Müllerian duct). Over gestation, the lower, stratified squamous epithelium replaces the columnar epithelium up to the level of the cervix. When columnar epithelium persists in the vaginal canal, it is called adenosis.

Note: women whose mothers took DES are at increased risk of developing this pathology.

Question 3

What will you see on histologic exam of a woman with adenosis?

Answer 3

Glandular tissue deeper in the walls of the vagina (circular crypts)

Question 4

____________ is a complication of adenosis.

Answer 4

Clear cell carcinoma

Question 5

Other than CCC, what does DES exposure cause?

Answer 5

Smooth muscle abnormalities in daughters and breast cancer in mothers

Question 6

What does DES cause in sons?

Answer 6

Nothing

Question 7

What is another (newer) term for sarcoma botryoids?

Answer 7

Embryonal rhabdomyosarcoma

Question 8

Histologically, what characterizes the cells diagnostic of embryonal rhabdomyosarcoma?

Answer 8

Rhabdomyoblasts present with cytoplasmic cross striations and stain positive for desmin and myogenin.

Question 9

Cancers of the vagina will spread to which lymph nodes?

Answer 9

Lower 1/3: inguinal

Upper 2/3: regional iliac