Pathology Of The Vulva And Vagina Flashcards
What are the characteristics of herpes simplex?
HSV 2 is more common cause
Women are more susceptible to it
Greatest risk is with neonates during birth
C section recommended
What are the microscopic features of herpes simplex?
Presence of prominent acute inflammatory infiltrate
Acantholytic keratinocytes with multinucleation, nuclear molding and chromatin margination(ground glass)
Cowdry A effect less common
What are the characteristics of molluscum contagiosum?
Small benign skin or mucosal lesions caused by pox virus
Gross feature:Presence of well circumscribed and umbilicated with caseous plug
Microscopic feature:Dome shaped papule with cup shaped center containing brightly eosinophilic cytoplasmic inclusions
What are the characteristics of condyloma acuminatum?
Genital warts usually caused by HPV 6,11
Hyperkeratosis and parakeratosis
What are the characteristics of lichen sclerosus?
Occurs in all age but most common in postmenopausal women
Not related to HPV
Pale pink or white plaques or macules may enlarge and coalesce to form dry, rough, scaly plaques
Advanced cases have tissue paper appearance
Marked thinning of epidermis with degeneration of basal cellsand hyperkeratosis
What are the characteristics of squamous cell hyperplasia ?
Not a disease in and of itself
Not used as a diagnosis unless a specific diagnosis cannot be made on a biopsy
Not associated with HPV
What are the two main types of vulvar intraepithelial neoplasia (VIN)?
Usual type VIN
Differentiated type VIN
What are the characteristics of usual type VIN?
HPV related, usually type 16
Commonly seen in 4th or 5th decade of life
More common in smokers and immunosuppressed women
May regress spontaneously
What are the characteristics of differentiated type VIN?
Not HPV related May arise in lichen sclerosus Commonly seen in 7th or 8th decade of life Much less likely to regress Often hypopigmented
What are the characteristics of HPV dependent vulvar squamous cell carcinoma?
More common in younger women (35-65 years old)
More common in smokers and the immunocompromised
Associated with U-VIN
Positive for p16; negative for p53
What are the characteristics of HPV independent vulvar squamous cell carcinoma?
Most common vulvar SCC
Common in older, postmenopausal women (55-85)
Associated with lichen sclerosus and differentiated VIN
Associated with p53 mutations
Negative for p16
Increased risk of recurrence and death after treatment
What are the characteristics of papillary hidradenoma?
Benign gland forming tumor with apocrine differentiation
Occurs usually between age 30-49
More common in caucasians
What are the characteristics of extramammary Paget disease?
Can be primary ( rarely invasive) or secondary (malignant)
Typically seen in middle aged women, around 4th decade of life and peaks around 65
Mainly seen in caucasians
Stain positive for mucin, carcinoembryonic antigen (CEA), and epithelial membrane antigen (EMA)
What are the characteristics of vulvovaginal candidiasis?
Commonly caused by candida albicans
Predisposing factors are diabetes, antibiotics use, pregnancy
Presents with curd like vaginal discharge
Filamentous hyphae or budding yeast can be found on KOH preparations
What are the characteristics of Trichomonas vaginalis ?
Caused by unicellular, flagellate, protozoan parasite
Transmitted by sexual contact
Has a yellow’ frothy discharge
Vaginal and cervical mucosa has a fiery red appearance and marked dilation of blood vessels- strawberry cervix
