Vagina: Difference between revisions
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=Normal vagina= | =Normal vagina= | ||
* | ===Microscopic=== | ||
*Non-keratinized squamous epithelium. | |||
Note: | |||
*Pieces of vagina are often submitted in the context of [[uterine prolapse]]. | *Pieces of vagina are often submitted in the context of [[uterine prolapse]]. | ||
**In this context the squamous epithelium may be keratinized (due to irritation). | |||
=== | |||
===Sign out=== | |||
====Not quite normal==== | |||
<pre> | |||
VAGINA, BIOPSY: | |||
- SUPERFICIAL VAGINAL MUCOSA WITH PARAKERATOSIS. | |||
- NEGATIVE FOR DYSPLASIA. | |||
</pre> | |||
<pre> | |||
VAGINAL VAULT, BIOPSY: | |||
- SQUAMOUS EPITHELIUM WITH COMPACT KERATIN, PARAKERATOSIS AND HYPERGRANULOSIS. | |||
- NEGATIVE FOR DYSPLASIA. | |||
- NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
=====Micro===== | |||
The sections show squamous epithelium with compact keratin, parakeratosis and | |||
hypergranulosis. The nuclei mature normally to the surface. No significant nuclear atypia is identified. Mitotic activity is not readily apparent. Minimal intracellular edema is present. No significant inflammation is identified. A very small amount of fibrous subepithelial tissue is present. | |||
=Vaginal cysts= | =Vaginal cysts= | ||
DDx:<ref name=medlineplus001509/> | DDx:<ref name=medlineplus001509/><ref name=pmid18390079/> | ||
*Vaginal inclusion cyst | *[[Vaginal inclusion cyst]] (epidermal inclusion cyst) - squamous epithelium. | ||
*[[Gartner's duct cyst]]. | *[[Gartner's duct cyst]] - cuboidal epithelium. | ||
*[[Bartholin's cyst]]. | *[[Bartholin's cyst]] - squamous or columnar cells, usu. inflamed. | ||
*[[Endometriosis]]. | *[[Endometriosis]]. | ||
* | *[[Müllerian cyst of the vagina|Müllerian cyst]] - endocervical epithelium. | ||
==Vaginal inclusion cyst== | ==Vaginal inclusion cyst== | ||
*[[AKA]] ''[[epidermal inclusion cyst]]''.<ref name=pmid18390079>{{Cite journal | last1 = Kondi-Pafiti | first1 = A. | last2 = Grapsa | first2 = D. | last3 = Papakonstantinou | first3 = K. | last4 = Kairi-Vassilatou | first4 = E. | last5 = Xasiakos | first5 = D. | title = Vaginal cysts: a common pathologic entity revisited. | journal = Clin Exp Obstet Gynecol | volume = 35 | issue = 1 | pages = 41-4 | month = | year = 2008 | doi = | PMID = 18390079 }}</ref> | |||
===General=== | ===General=== | ||
*Most common vaginal cyst.<ref name=medlineplus001509>URL: [http://www.nlm.nih.gov/medlineplus/ency/article/001509.htm http://www.nlm.nih.gov/medlineplus/ency/article/001509.htm]. Accessed on: 6 July 2010.</ref> | *Most common vaginal cyst.<ref name=medlineplus001509>URL: [http://www.nlm.nih.gov/medlineplus/ency/article/001509.htm http://www.nlm.nih.gov/medlineplus/ency/article/001509.htm]. Accessed on: 6 July 2010.</ref> | ||
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===Microscopic=== | ===Microscopic=== | ||
Features: | Features:<ref name=pmid18390079/> | ||
* | *Cyst lined by non-keratinized squamous epithelium. | ||
*+/-Inflammation. | |||
DDx: | |||
*[[Bartholin's cyst]]<ref name=pmid22935309>{{Cite journal | last1 = Apostolis | first1 = CA. | last2 = Von Bargen | first2 = EC. | last3 = DiSciullo | first3 = AJ. | title = Atypical presentation of a vaginal epithelial inclusion cyst. | journal = J Minim Invasive Gynecol | volume = 19 | issue = 5 | pages = 654-7 | month = | year = | doi = 10.1016/j.jmig.2012.03.027 | PMID = 22935309 }}</ref> - clinical information essential. | |||
===Sign out=== | |||
<pre> | |||
CYST WALL, VAGINA, EXCISION: | |||
- CONSISTENT WITH BENIGN VAGINAL INCLUSION CYST. | |||
- SQUAMOUS MUCOSA WITH FOCAL KERATINIZATION. | |||
- NEGATIVE FOR MALIGNANCY. | |||
</pre> | |||
=Viral infections= | =Viral infections= | ||
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===Microscopic=== | ===Microscopic=== | ||
Features:<ref name=herpes/> | Features:<ref name=herpes/> | ||
*Keratinocytes enlargement + acanthosis. | *Keratinocytes enlargement + [[acanthosis]]. | ||
**Intraepidermal vesicles & bullae. | **Intraepidermal vesicles & bullae. | ||
*Nuclear changes - 3 Ms: | *Nuclear changes - 3 Ms: | ||
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*[http://missinglink.ucsf.edu/lm/DermatologyGlossary/img/Dermatology%20Glossary/Glossary%20Histo%20Images/herpes_high_power.jpg Herpes (ucsf.edu)]. | *[http://missinglink.ucsf.edu/lm/DermatologyGlossary/img/Dermatology%20Glossary/Glossary%20Histo%20Images/herpes_high_power.jpg Herpes (ucsf.edu)]. | ||
*[http://missinglink.ucsf.edu/lm/DermatologyGlossary/img/Dermatology%20Glossary/Glossary%20Histo%20Images/herpes_low_power.jpg Herpes - skin (ucsf.edu)]. | *[http://missinglink.ucsf.edu/lm/DermatologyGlossary/img/Dermatology%20Glossary/Glossary%20Histo%20Images/herpes_low_power.jpg Herpes - skin (ucsf.edu)]. | ||
=Other= | |||
==Vaginal mucosa with irritation== | |||
:''Rectocele'', ''cystocele'', ''vaginal mucosa'' and ''vaginal repair'' redirect here. | |||
===General=== | |||
*Seen in the context of vaginal repairs for ''rectocele'' or ''cystocele''. | |||
===Microscopic=== | |||
Features: | |||
*Squamous mucosa with hyperkeratosis. | |||
*Negative for atypia. | |||
*Negative for inflammation. | |||
===Sign out=== | |||
<pre> | |||
Vaginal Mucosa, Excision During Vaginal Repair: | |||
- Squamous mucosa with compact keratin layer. | |||
- NEGATIVE for significant inflammation. | |||
- NEGATIVE for dysplasia and NEGATIVE for malignancy. | |||
</pre> | |||
=Vaginal cancer= | =Vaginal cancer= | ||
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VAGINA, BIOPSY: | VAGINA, BIOPSY: | ||
- MODERATE VAGINAL INTRAEPITHELIAL NEOPLASIA (VAIN 2). | - MODERATE VAGINAL INTRAEPITHELIAL NEOPLASIA (VAIN 2). | ||
</pre> | |||
<pre> | |||
VAGINA, BIOPSY: | |||
- MILD VAGINAL INTRAEPITHELIAL NEOPLASIA (VAIN 1). | |||
</pre> | </pre> | ||