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OB/GYN Boards by Subject > Vulvar and vaginal pathology > Flashcards

Vulvar and vaginal pathology Flashcards

1
Q

Presentation of lichen sclerosis

A

Postmenopausal woman, itching

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2
Q

Distribution of lichen sclerosis

A

Peri-introital, perianal

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3
Q

Presentation of lichen planus

A

Itching, flat plaque-like papules that are red, white, or purple

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4
Q

Distribution of lichen planus

A

Vulvar skin, mucosa of lower genital tract, possible oral mucosa involvement

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5
Q

Presentation of lichen simplex chronicus OR squamous cell hyperplasia

A

Itching lesion, leathery skin thickening, erythematous skin with greyish layer of keratin

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6
Q

Presentation of psoriasis of vulva

A

Erythematous plaques usually without characteristic flaking found other locations

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7
Q

Distribution of psoriasis

A

Lateral aspect of labia majora or labio-crural folds

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8
Q

Presentation of condyloma accuminatum

A

Young, warty lesion

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9
Q

Histology: thin epithelium, blunted rete pegs, chronic inflammatory infiltrate

A

Lichen sclerosis

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10
Q

Histology: lymphocytic infiltrate, necrosis of basal keratinocytes

A

Lichen planus

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11
Q

Histology: thick epithelium, with hyper- and para-keratosis, collagenous dermal layer, superficial inflammatory infiltrate

A

Lichen simplex chronicus

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12
Q

Histology: Thick epithelium with hyper- and para-keratosis, collagenous dermal layer

A

Squamous cell hyperplasia

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13
Q

Histology: stratified squamous epithelium, features of HPV infection (koilocytosis, multinucleated cells, parabasal hyperplasia)

A

Condyloma accuminata

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14
Q

Treatment for most vulvar dematoses

A

Topical corticosteroids

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15
Q

Second and third line treatment for lichen planus

A

Cyclosporin, retinoids; complete surgical resection

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16
Q

Treatment for condyloma accuminata

A

Aldara, Condylox, Interferon alpha, excision, laser ablation, cryotherapy

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17
Q

Most common skin cancer diagnosis (less common on vulva)

A

Basal cell carcinoma

18
Q

Smooth pearly papule with rolled borders

A

Basal cell carcinoma

19
Q

Treatment for basal cell carcinoma

A

Local excision

20
Q

Scaly plaque-like lesion, necrosis, hemorrhagic, hyperkeratotic

A

Squamous cell carcinoma

21
Q

Treatment for squamous cell carcinoma

A

Wide radical excision +/- LND

22
Q

Melanoma staging based on…

A

Depth of invasion (<1 mm is microinvasive)

23
Q

Treatment for VIN

A

Surgical excision vs laser vaporization (can be better for multifocal as long as not VIN3 - no specimen), occasionally imiquimod

24
Q

Treatment for VAIN

A

Surgical excision vs laser vaporization vs 5-FU cream (can cause vulvar toxicity) vs imiquimod

25
Q

Proportion of GYN cancers that are vulvar / vaginal

A

5%

26
Q

Risk factors for vulvar cancer

A

Similar to cervical cancer, HPV implicated in 40%, increasing age

27
Q

Common histology of vulvar cancer

A

Squamous cell (90%)
Melanoma (5%)
Others basal cell, sarcoma, adenocarcinoma, Bartholin’s Paget’s

28
Q

FIGO stages of vulvar cancer by location

A

I - vulva
II - adjacent structures (urethra, lower vagina, anus)
III - inguinofemoral LNs
IV - distant

29
Q

Vulvar cancer invasion depth requiring groin LND

A

> 1 mm

30
Q

Vulvar cancer treatment

A

Individualized, including resection, LND, radiation, chemoradiation (?)

31
Q

Vulvar cancer prognostic factors

A

Depth of invasion (most important), lymph node status, extent of disease (stage)

32
Q

Demographics for Paget’s disease

A

Caucasian, postmenopausal

33
Q

Sharply demarcated red velvety lesion with islands of white hyperkeratosis, pruritis or pain

A

Paget’s disease

34
Q

Histology: intraepithelial proliferation of glandular-like cells (large, clear cytoplasm, signet ring cells)

A

Paget’s disease

35
Q

Malignancy associations with Paget’s disease

A

25% associated with another primary malignancy (breast, urinary tract, cervix, or rectal cancer)
15-20% have underlying adenocarcinoma

36
Q

Treatment for Paget’s disease

A

Excision, rule out additional malignancy

37
Q

Histology of Bartholin’s gland cancer

A

Squamous 50%

Adenocarcinoma 50%

38
Q

Vaginal cancer definition

A

Cancer arising only from vagina, no cervical or vulvar involvement

39
Q

Risk factors for vaginal cancer

A

HPV-related probably, DES exposure in-utero (clear cell adenocarcinoma)

40
Q

Histology of vaginal cancer

A

Squamous 85%

Adenocarcinoma 10%

41
Q

FIGO stages of vaginal cancer by location

A

I - vagina
II - subvaginal tissue
III - pelvic sidewall, obstructed ureter
IV - adjacent organs, distant organs

42
Q

Treatment of vaginal cancer

A

Radiation; surgery in selected cases; maybe chemo-RT, extrapolated from cervical cancer data

OB/GYN Boards by Subject (22 decks)

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