Saturday, May 07, 2005

Gynecological Pathology I




Surface Features

Other Features

Vulvar Malgnancies

Vulvar Intraepithelial Neoplasia


Varying degrees of loss of maturation of squamous cells

Single or multiple plaques or papules

Co-exists with cervical dysplasia

Invasive squamous cell carcinoma

Keratinizing squamous cell histology

Ulcerated exophytic lesions

Most common vulvar malignancy

Verrucous carcinoma

Well differentiated, locally invasive

Giant condyloma

Unlikely to metastasize, subset of invasive squamous cell carcinoma

Extramammary Paget’s Disease

Intraepithelial adenocarcinoma in the vulva

Red, moist plaque

Malignant Melanoma

Same as skin melanoma

Second most common malignant tumor in vulva

Benign Disorders of Vulva

Lichen Sclerosis

Atrophic epidermis, hyalinized epidermis

White plaques

Squamous hyperplasia

Thickened epidermis

White plaques


Benign tumor

Sweat gland origin – apocrine


Benign tumor

Sweat gland origin – eccrine


Benign tumor



Failure of squamous cell maturation

Absence of estrogen


DES exposure, sporadic

Abnormal retention of embryologic glandular epithelium

Benign disorder

Squamous cell carcinoma

Vaginala intraepithelial neoplasia

Most common vaginal neoplasm, assoc w cervical and vulvar SSC, 80% spread from cervix

Clear Cell Adenocarcinoma

Prior DES exposure

Peak age 17-22, very uncommon

Embryonal Rhabdomyosarcoma

Sarcoma of primitive skeletal muscle

Sarcoma botryoides – grape like

Seen in young children


Cervical Intraepithelial Neoplasia

HPV esp types 16,18, 31, 33, 35 à Inactivation of suppressor gene products p53 and Rb

Occurs in transition zone

Degree of loss of maturation in squamous cells

Invasive Carcinoma of Cervix

Microinvasion, non-keratinizing squamous cel,l Advancing disease can obstruct ureters, invade locally

Adenocarcinoma – less common, more aggressive

2nd most common cause of death WW

No comments: