Vulva/Vagina Pathology Flashcards

1
Q
A

Lichen Sclerosus of the Vulva

Premenarchal or postmenopausal

Painful, pruritic

Thin epidermis

1-5% develop squamous cell carcinoma

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2
Q
A

Lichen Simplex Chronicus

Secondary to chronic irritation underlying inflammatory dermatosis

Also can appear as leukoplakia, epthelial thickening, hyperkeratosis, dermal chronic inflammation

No known predilection for malignancy

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3
Q
A

Condyloma Accuminata

VIN-1 (warty lesion)

Papillary, raised or flat

On anogenital surfaces

Single or multiple, small or very large

Koilocytosis (perinuclear cytoplasm vacuuolization and wrinkled nuclear contours)

Assoc with HPV 6 and 11

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4
Q
A

Vulvar dysplasia

VIN-2 & VIN-3 – high grade

Associated with HPV 16 & 18

Full thickness dysplasia: nuclear atypia, high nuclear:cytoplasmic ratio, abundant mitosis

Progression to invasive squamous cell carcinoma

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5
Q
A

Carcinoma of Vulva

Mostly > 60 yo

90% squamous cell carcinoma

Two forms:

  1. high risk HPV associated – preceded by VIN, multifocal, poorly differentiated, higher incidence in smokers, immunodeficiency
  2. in older age group – preceded by reactive changes, mainly Lichen sclerosis, well differentiated, keratinizing
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6
Q
A

Extramammary Paget’s Disease

Red, scaly plaques

Intraepidermal proliferation of malignant cells

Most commonly de novo from epidermal progenitor cells

Large pale cells in the epidermis (glandular)

Differential diagnosis: malignant melanoma, squamous cell carcinoma

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7
Q
A

CK7 positive Paget cells

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8
Q

What is clear cell adenocarcinoma of the vagina associated with?

A

Women who had exposure to DES in utero

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9
Q
A

Embryonal (botryoid) Rhabdomyosarcoma

Rare primary vaginal malignancy

Infance and children <5 years

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