Flashcards in CH13 - Female Genital System and Gestational Pathology Deck (337)
What is the vulva?
Anatomically includes the skin and mucosa of the female genitalia external to the hymen (labia majora, labia minora, mons pubis, and vestibule)
What is the vulva lined by?
What is a bartholin cyst?
Cystic dilation of the Bartholin gland
What are the bartholin glands?
One Bartholin gland is present on each side of the vaginal canal and produces mucus-like fluid that drains via ducts into the lower vestibule.
Bartholin cyst arises due to what?
inflammation and obstruction of gland
In whom does bartholin cyst usually occur?
in women of reproductive age
How does bartholin cyst present?
as a unilateral, painful cystic lesion at the lower vestibule adjacent to the vaginal canal
What is condyloma?
Warty neoplasm of vulvar skin, often large
What is condyloma most commonly due to?
HPV types 6 or 11 (condyloma acuminatum) secondary syphilis (condyloma latum) is a less common cause. Both are sexually transmitted.
Histologically, how are HPV-associated condylomas characterized?
What is the relationship between condylomas and carcinoma?
They rarely progress to carcinoma (6 and 11 are low-risk HPV types)
How is lichen sclerosis characterized?
by thinning of the epidermis and fibrosis (sclerosis) of the dermis
How does lichen sclerosis present?
as a white patch (leukoplakia) with parchment-1ike vulvar skin
What is lichen sclerosis most commonly seen in?
What is a possible etiology for lichen sclerosis?
Possibly autoimmune etiology
Is lichen sclerosis associated with carcinoma?
Benign, but associated with a slightly increased risk for squamous cell carcinoma
What is lichen simplex chronicus?
Characterized by hyperplasia of the vulvar squamous epithelium
How does lichen simplex chronicus present?
as leukoplakia with thick, leathery vulvar skin
What is lichen simplex chronicus associated with?
chronic irritation and scratching
Is lichen simplex chronicus associated with carcinoma?
Benign; no increased risk of squamous cell carcinoma
What is vulvar carcinoma?
Carcinoma arising from squamous epithelium lining the vulva
What is the frequency of vulvar carcinoma?
Relatively rare, accounting for only a small percentage of female genital cancers
How does vulvar carcinoma present?
In vulvar carcinoma what may be required and why?
biopsy to distinguish carcinoma from other causes of leukoplakia
What is the etiology for vulvar carcinoma?
may be HPV related or non-HPV related.
What is HPV-related vulvar carcinoma due to?
high-risk HPV types 16 and 18.
What are the risk factors for HPV-related vulvar carcinoma related to?
HPV exposure and include multiple partners and early first age of intercourse; generally occurs in women of reproductive age
From where does HPV related vulvar carcinoma arise?
It arises from vulvar intraepithelial neoplasia (VIN), a dysplastic precursor lesion characterized by koilocytic change, disordered cellular maturation, nuclear atypia, and increased mitotic activity
When does non-HPV related vulvar carcinoma arise?
most often, from long-standing lichen sclerosis,