Vagina - Pathoma Flashcards
What type of epithelium lines the vagina?
Non-keratinized stratified squamous epithelium
What is Adenosis?
Focal persistance of columnar epithelium in upper 2/3 of vagina
Females exposed to what have an increased incidence of adenosis?
DES = diethylstillbesterol
drug used to treat post-menopausal sx and prevention of miscarriage
What do you call a malignant proliferation of glands will clear cytoplasm?
Clear cell adenocarcinoma
How does Clear cell adenocarcinoma develop?
Rare complication of DES-associated vaginal adenosis
Which patient populations could be exposed to DES and subsequently develop DES complications?
DES mom (in the 1960’s) => breast carcinoma
DES daughter => adenosis, Clear cell adenocarcinoma, dysfunctional uterine development
DES son => no complications
What do you call a rare, malignant mesenchymal proliferation of immature skeletal muscle in the vagina?
Embryonal Rhabdomyosarcoma
variant of Sarcoma botryoides, which means grape-like mass
What is the interesting presentation of Embryonal Rhabdomyosarcoma that gets tested on boards?
Bleeding and a grape-like mass protruding from the vagina
Affects girls
What is the key cell that forms the tumor in Embryonal Rhabdomyosarcoma?
Rhabdomyoblast = immature spindle-shaped cells with cytoplasmic cross-striations
How do you diagnose Embryonal Rhabdomyosarcoma?
Positive IHC stains for desmin and myogenin
What is Vaginal Carcinoma usually related to?
high-risk HPV (16, 18, 31, 33)
What is the precursor lesion in Vaginal Carcinoma?
epithelial dysplasia = vaginal intraepithelial neoplasia (VAIN)
Which lymph nodes are involved in a cancer from the lower 1/3 of the vagina?
inguinal lymph nodes
Which lymph nodes are involved in a cancer from the upper 2/3 of the vagina?
regional iliac lymph nodes
