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Difference between revisions of "Vulva"
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This article addresses the basics of '''vulva''', from a pathologic perspective. | This article addresses the basics of '''vulva''', from a pathologic perspective. | ||
== | =Malignant neoplasms overview= | ||
==Most common malignancies== | |||
Most common malignancies of vulva:<ref name=Ref_WMSP459>{{Ref WMSP|459}}</ref> | |||
#Invasive [[squamous cell carcinoma]]. | |||
#[[Malignant melanoma]]. | |||
==Squamous cell carcinoma== | |||
{{Main|Squamous cell carcinoma}} | |||
Like SCC elsewhere. | |||
Precursor | ===Precursor lesions for SCC=== | ||
*Vulvar intraepithelial neoplasia (VIN). | *Vulvar intraepithelial neoplasia (VIN). | ||
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*''Differentiated VIN''. | *''Differentiated VIN''. | ||
**''Differentiated VIN'' is mostly irrelevant as it is basically never seen alone, i.e. it usually accompanies cancer. | **''Differentiated VIN'' is mostly irrelevant as it is basically never seen alone, i.e. it usually accompanies cancer. | ||
Low grade pre-cancerous lesions (VIN) are typically HPV positive, while high grade pre-cancerous lesions and cancer are less often HPV positive.<ref name=pmid19115209>{{cite journal |author=De Vuyst H, Clifford GM, Nascimento MC, Madeleine MM, Franceschi S |title=Prevalence and type distribution of human papillomavirus in carcinoma and intraepithelial neoplasia of the vulva, vagina and anus: a meta-analysis |journal=Int. J. Cancer |volume=124 |issue=7 |pages=1626–36 |year=2009 |month=April |pmid=19115209 |doi=10.1002/ijc.24116 |url=}}</ref> | |||
==Classic vulvar intraepithelial neoplasia== | ==Classic vulvar intraepithelial neoplasia== | ||
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ASIDE: [[p16]] can be thought of as a poor man's HPV test. | ASIDE: [[p16]] can be thought of as a poor man's HPV test. | ||
=Neoplasms (non-malignant)= | |||
A short DDx:<ref>{{Ref WMSP|456}}}}</ref> | |||
*[[Granular cell tumour]]. | |||
*[[Leiomyoma]]. | |||
*[[Fibroepithelial polyp]]. | |||
*[[Paget's disease]]. | |||
==Hidradenoma papilliferum== | |||
===General=== | |||
*Dermal thingy; hidradenoma = tumour of sweat duct epithelium.<ref>URL: [http://medical-dictionary.thefreedictionary.com/hidradenoma http://medical-dictionary.thefreedictionary.com/hidradenoma]. Accessed on: 14 April 2011.</ref> | |||
*[[AKA]] ''papillary hidradenoma''.<ref>Hidradenoma papilliferum. Stedman's Medical Dictionary. 27th Ed.</ref> | |||
*Looks like ''intraductal papilloma of the breast''.<ref>{{Ref PBoD|1067}}</ref> | |||
===Microscopic=== | |||
Features: | |||
*Cystic spaces. | |||
*Epithelium with apocrine differentiation (as demonstrated by apocrine snouts). | |||
*Well-circumscribed. | |||
Images: | |||
*[http://farm4.static.flickr.com/3019/2646470314_12fb77d3ec_z.jpg Hidradenoma papilliferum (flickr.com)]. | |||
Notes: | |||
*No attachment to epidermis. | |||
*No nuclear changes suggestive of malignancy. | |||
=Other= | |||
This is grab bag of non-neoplastic stuffs. | |||
==Lichen sclerosus== | ==Lichen sclerosus== | ||
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===General=== | ===General=== | ||
*Common. | *Common. | ||
===Microscopic=== | ===Microscopic=== | ||
Features: | Features: | ||
* | *Cyst with squamous or urothelial epithelium.<ref>[http://pathologyoutlines.com/vulva.html#bartholincyst http://pathologyoutlines.com/vulva.html#bartholincyst]</ref> | ||
=See also= | |||
*[[Gynecologic pathology]]. | *[[Gynecologic pathology]]. | ||
*[[Uterus]]. | *[[Uterus]]. | ||
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*[[Anus]] - anal intraepithelial neoplasia. | *[[Anus]] - anal intraepithelial neoplasia. | ||
=References= | |||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Gynecologic pathology]] | [[Category:Gynecologic pathology]] | ||