Vaginal Path III

Question 1

how does invasice SCC of the vulva present

Answer 1

nodules/masses wiht background of leukoplakia

Question 2

majority of invasice vulvar carcinomas are what type

Answer 2

SCC

Question 3

majority SCC of vulva is what pattern

Answer 3

warty and bowenoid (HPV)
repro- age women
assoc with HPV 16 18 but also type 33

Question 4

ulcerated mass on vulva, next step?

Answer 4

malignant until proven otherwise

Question 5

what is the pattern of SCC of vulva that presents in elderly women (mid 70s)

Answer 5

keratinizing type (not HPV)

Question 6

precursor leasions to keratinizing SCC of the vulva

Answer 6

long stnading LS&A and chronic inflammation

VIN simplex or differentiated (not HPV)

Question 7

which type SCC of the vulva is HPV releated

Answer 7

the warty bowenoid type that is seen in younger women

Question 8

describe spread of lymph invasion starting in vulva

Answer 8

inguinal to pelvic to iliac to para-aortic

Question 9

Tx SCC of vulva

Answer 9

vulvectomy and lymphadenectomy

Question 10

the deeper the invasion of SCC of the vulva corresponds to what

Answer 10

chance of inguinal metastasis

Question 11

gross findings of SCC of the vulva

Answer 11

exophytic mass or endophytic ulcer or both
can be labia minor or majora
10% multifocal when assoc with condyloma

Question 12

keratin pearls are seen in bx taken from vulvular lesion

Answer 12

invasive SCC

Question 13

stage 1 SCC carcinoma prognosis?
stage 3?
4?

Answer 13

1: 80% 5 yr
3: 40% 5 yr
4: 10% 5 yr

Question 14

where does accessory breast tissue form

Answer 14

along the milk line, extending to vulva

Question 15

what is a papillary hidradenoma

Answer 15

sharply circumscribed nodule in vulva with normal overlying skin
considered a benign tumor from apocrine glands

Question 16

pruritic red crusted sharply demarcated area on labia majora in elderly woman

Answer 16

extramammary paget disease

Question 17

is there an underlying carcinoma tumor mass in paget disease of the vulva

Answer 17

no

Question 18

what do papillary hidradenomas feel like

Answer 18

nodule that is moveable

Question 19

histo from vulva shows double layer of columnar/myoepithelial cells

Answer 19

papillary hidradenoma

Question 20

extramammary paget dsease thought to arise from what

Answer 20

primitive germline cells of mammary like gland ducts in vulvar skin

Question 21

what do paget cells look like

Answer 21

halo cells

epidermal appendegaes

Question 22

what can you stain paget cells with

Answer 22

PAS +, mucin +
CEA+
EMA + on IHC stain
(S100 and Melanin A negative)

Question 23

Tx for extramammary paget disease

Answer 23

wide local excision
may recur
Need to look for synchronous tumors

Question 24

what type of melanoma is typical on vulva

Answer 24

nodular type

Question 25

cytologic stains to use for malignant melanoma of vulva

Answer 25

S100 and melanin A +

Question 26

pagetoid histology is what and seen when

Answer 26

pattern of individual clear cells infiltrating through epidermis also seen in melanoma

Question 27

see discoloration of vulva | next step

Answer 27

biopsy | have to rule out melanoma

Question 28

when is the glandular epithelium of embryo vagina replced by squamous epithelium

Answer 28

18 weeks

Question 29

what historically caused vaginal adenosis

Answer 29

DES when women were given this with miscarriages

Question 30

women given DES for miscarriages could have daughters with what cancer

Answer 30

clear cell carcinom of the vagina

Question 31

DES exposure in males increases risk for what

Answer 31

cryptorchism and hypospadius

Question 32

SCC of vulva arises from what

Answer 32

Vaginal Intraepithelial neoplasm

Question 33

Prognosis SCC depends on what

Answer 33

size and nodal spread

Question 34

What is embryonal rhabdomyosarcoma

Answer 34

neoplasm of girls <3 cm | grows by local invasion with spread to nodes at distant sites

Question 35

where do gartner duct cysts arise from

Answer 35

wolffian remnant on lateral vaginal wall

Question 36

path of a gartner duct cyst

Answer 36

simple cyst with monolayer of benign cuboidal epithelium

Question 37

Tx of gartner duct cyst

Answer 37

excisional Bx

Question 38

what does histo of clear cell carcinoma of the vagina look like

Answer 38

vacuolated tumor cells with gland formation

Question 39

what tumor looks like a grape cluster

Answer 39

embryonal rhabdomyosarcoma

Question 40

embryonal rhabdomyosarcoma are often misDx as what

Answer 40

inflammatory polyp

Question 41

tumor cells show elongated muscle cells with cross striations?

Answer 41

embryonal rhabdomyosarcoma