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Vagina Developmental Anomalies (Vaginal intraepithelial Neoplasia,…
Vagina Developmental Anomalies
Double vagina
Bicornuate uterus
Uterus didelphys
Mesonephric Cyst [Gartner's Dust Cyst]
Derive: Wolffian duct rests
low cuboidal
in lateral walls of vagina
non-mucin secreting cell
devoid of cytoplasmic mucicarmine or PAS+ material
Vaginal intraepithelial Neoplasia,
Risk factors:
Squamous neoplasia in lower Genital tract
HPV infection
Irradiation, utero DES exposure
Immunosuppresion
5% Vain progress to invasive squamous CA
Microscopic:
sim. to squamous intraepithelial lesions of the cervix
Macroscopic
NO grossly identifiable lesion
Epithelium raised white or pink
Vaginal Carcinoma
Primary vaginal Carcinoma: extremely uncommon 1%
95% are squamous cell carcinoma
assoc. w/ HPV
RF:
early sex acts
sex partners
Greatest: *previous carcinoma of the cervix or vulva
Adenocarcinoma
Clinical:
Rare
0.14% develops
19 yrsMedian age
A. wall vagina, upper 2/3rds
Macro:
Polypoid & nodular
flat or ulcerated
Clear Cell Adenocarcinoma
Micro:
lesscommon
tubular pattern resembling em CA
papillary pattern
cords cell w/ eosinophilic cytoplasm
Common=*tubulocystic pattern
solid sheets of clear cells
Embryonal Rhabdomyosarcoma [Sarcoma botryoides]
Clin:
infants & children
rare, vulva & vagina, 10yrs of age
Arise:perineal or labial area
Macro:
Polypoid, solid
bunch of grapes
Micro:
Tumor cells reactive
Desmin
Muscle-specific actin
*Myoglobin
cambium layer, cross striations
Rhabdomyoblast cross-striations <15% cases