外阴和阴道镜检查何时及何地取活检.pptxVIP

Examination/Colposcopy of the Vulva and Vagina– When and where to biopsy（外阴和阴道镜检查—何时及何地取活检）;Disclosures声明;Objectives目的;The vulva外阴;Diagnosis of LSIL / WartsLSIL/湿疣的诊断;52 yo female52岁女性Presents with an itchy growth. 瘙痒进行性加重;Genital Warts Diagnosis 外生殖器湿疣诊断;Genital Warts Treatment外阴湿疣的治疗;Symptoms/presentation症状/表现;;Pitfalls of Vulvar Colposcopy外阴阴道镜的误区;58 yo, multiple procedures for vulvar HSIL, 45 pack year history 58岁，多次外阴HSIL，45年病史;White Vulvar HSIL白色外阴HSIL病变 ;Courtesy of Hope Haefner, MD;Courtesy of Hope Haefner, MD;Concerning Features of Vulvar lesions 外阴病变的相关特征;Punch Biopsy钻孔活检;Vulvar Punch Biopsy;Tischler ;Acceptable treatment modalities可接受治疗方法:;Vulvar Excisional biopsy外阴切除活检;Margins and DepthVulvar HSIL;49 yo, asymptomatic, noted by provider while getting a Pap test 49岁，无症状，行巴氏涂片时发现结节;Vulvar HSIL may be associated with invasive cancer外阴HSIl可能与浸润癌相关;;65 yo female non-smoker, no medical problems 65岁女性，不吸烟，无并发疾病;Imiquimod treatment of vulvar HSIL– Results from systematic review (n=162 patients)咪喹莫特治疗外阴部HSIL——系统性回顾结果（n=162）;After 3 months imiquimod咪喹莫特治疗3月后;HPV-associated HSIL: Risk of Progressive Disease HPV相关的HSIL:疾病进展相关风险;VIN differentiated分化型阴道上皮内瘤变;Differentiated VIN diagnosed infrequently compared to vulvar HSIL (Usual VIN )与常见VIN病变相比，分化型VIN较少;Acceptable treatment is Surgical excision 可接受的治疗方案为外科切除手术;Paget Disease Association with Adenocarcinoma与腺癌相关的佩吉特病;Summary- Vulva总结-外阴;The Vagina阴道;60 yo ;Before acetic acid醋酸白之前;Acetic acid醋酸白之后;Hospital of Fudan University;INSERT PATH;Diagnosis: Right vagina HSIL Left vagina normal 诊断： 右侧阴道壁HSIL 左侧阴道壁正常;Vaginal Colposcopy阴道镜;Acetowhite Effects in the Vagina 醋酸白在阴道的影响;Vaginal Colposcopy阴道镜 ;Lugol’s Iodine Staining 卢戈氏碘染色;Lugol’s Solution卢戈氏液;If no lesion seen on cervix to explain abnormal cytology - look at vagina 如果细胞学异常，宫颈未见病变，检查阴道 Lugol solution can delineate lesions otherwise missed with colposcopy卢戈氏液可以发现阴道镜无法直接发现的病变;Vaginal Biopsy阴道活检;Characteristics of VaIN VaIN特征;Colp