Pathology of the Female Genital Tract 1女性生殖道病理1.pptxVIP

Vulvar Diseases: Can be divided to non-neoplastic and neoplastic diseases. The neoplastic diseases are much less common. Of those, squamous cell carcinoma is the most common. Pathology of the lower female genital tract most common in postmenopausal women (It occurs in all age groups;It may also be encountered elsewhere on the skin). Clinically: smooth, white plaques or papules. The skin is thinned out and resembles paper. The labia becomes atrophic and stiffened. Microscopically: thinning of the epidermis and disappearance of rete pegs, hydropic degeneration of the basal cells, superficial hyperkeratosis, and dermal fibrosis with a scant perivascular, mononuclear inflammatory cell infiltrate. Pathogenesis: is uncertain, (?)autoimmune reaction lichen sclerosus is not pre-malignant by itself women with symptomatic lichen sclerosus have approximately a 15% chance of developing SCC in their lifetime. Licken sclerosus Lichen sclerosus Lichen simplex chronicus is the end result of many inflammatory conditions It appears clinically as an area of leukoplakia. Microscopically: epithelial thickening, expansion of the stratum granulosum, and significant surface hyperkeratosis. Leukocytic infiltration of the dermis. The hyperplastic epithelial changes show no atypia. There is generally no increased predisposition to cancer, but suspiciously, lichen simplex chronicus is often present at the margins of adjacent cancer of the vulva. Lichen Simplex Chronicus Condylomas are anogenital warts characteristic histologic appearance = perinuclear cytoplasmic vacuolization (koilocytosis) with nuclear pleomorphism. (esp. type 6 and type11 ) transmitted sexually. The types of HPV isolated from the cancers differ from those most often found in condylomas. Vulvar condylomas are not precancerous but may coexist with foci of intraepithelial neoplasia in the vulva (VIN grade I). VIN I and condylomas, both caused by HPV of low malignant potential, should be segregated from high g