Non-Neoplastic and Tumors of the Vulva

Questions and Answers

What is the primary cause of cervicitis?

Hormonal changes

Sexually transmitted infections (correct)

Autoimmune disorders

Genetic mutations

What is the primary characteristic of lichen sclerosus?

Hyperkeratosis of the skin

Marked epithelial thickening

Benign dermatosis with no cancer risk

Dermal fibrosis with atrophic epithelium (correct)

Which organism is responsible for approximately 40% of cervicitis cases in sexually transmitted disease clinics?

Herpes simplex virus

Candida spp.

Neisseria gonorrheae

Chlamydia trachomatis (correct)

What screening test is considered the most successful for detecting cervical cancer?

Pap smear Signup and view all the answers

Which form of condyloma is more commonly seen on anogenital surfaces?

Condylomata acuminata Signup and view all the answers

What is a significant risk associated with lichen sclerosus?

Development of squamous cell carcinoma Signup and view all the answers

At what age does the peak incidence of Cervical Intraepithelial Neoplasia (CIN) typically occur?

30 years Signup and view all the answers

In which demographic is non-HPV-related vulvar squamous cell carcinoma most commonly seen?

Older women Signup and view all the answers

Which factor is likely to increase the risk of developing CIN and invasive cervical carcinoma?

Sexual transmission of HPV Signup and view all the answers

Which of the following is NOT true regarding condylomata?

Condylomata lata are the most commonly seen form today. Signup and view all the answers

Which of the following statements about cervical cancer and CIN is TRUE?

CIN can be detected by cytologic examination before invasive cancer development. Signup and view all the answers

What type of cancers commonly arises from the cervix?

Squamous cell carcinoma Signup and view all the answers

What histopathological feature is associated with lichen simplex chronicus?

Epithelial thickening Signup and view all the answers

What percentage of vulvar carcinomas is squamous cell carcinoma?

90% Signup and view all the answers

Which characteristic is associated with cervicitis?

Purulent vaginal discharge Signup and view all the answers

Which condition is often present at the margins of established vulvar cancer?

Lichen simplex chronicus Signup and view all the answers

What is the primary function of the BRCA1 and BRCA2 genes?

DNA repair Signup and view all the answers

Which of the following genetic conditions is associated with mutations in the p53 gene?

Li-Fraumeni syndrome Signup and view all the answers

What was observed regarding the use of combined estrogen plus progestin hormone therapy?

Increases the risk of breast cancer Signup and view all the answers

How does ionizing radiation to the chest affect breast cancer risk?

It increases the risk only in women irradiated before age 30 Signup and view all the answers

What percentage of women irradiated for Hodgkin lymphoma in their teens and 20s develop breast cancer?

20% to 30% Signup and view all the answers

Which of the following is NOT considered a well-established risk factor for breast cancer?

Genetic mutations in BRCA3 Signup and view all the answers

What is the characteristic appearance of cysts in fibrocystic changes?

Cysts lined by flattened or cuboidal epithelial cells Signup and view all the answers

Which of the following is NOT included in proliferative breast disease without atypia?

Atypical ductal hyperplasia Signup and view all the answers

What type of breast tumor is the most common benign neoplasm in females?

Fibroadenoma Signup and view all the answers

In which demographic do fibroadenomas most commonly appear?

Women in their thirties Signup and view all the answers

What is a common feature of phyllodes tumors?

They have a leaflike appearance Signup and view all the answers

Which statement about atypical lobular hyperplasia is true?

It is considered a precursor to breast cancer. Signup and view all the answers

What contributes to the development of fibroadenomas?

Increased estrogen activity Signup and view all the answers

Which characteristic is associated with sclerosing adenosis?

Proliferation of ductal epithelium without atypia Signup and view all the answers

What characteristic is associated with the most malignant breast tumors?

Increased stromal cellularity Signup and view all the answers

Which symptom is commonly associated with intraductal papilloma?

Serous or bloody nipple discharge Signup and view all the answers

At what age group is breast cancer most commonly diagnosed?

Older than 50 years Signup and view all the answers

What percentage of breast cancer cases metastasize to distant sites?

15% Signup and view all the answers

Which group of women is most likely to carry a breast cancer susceptibility gene?

Women with bilateral breast cancer and a family history Signup and view all the answers

What is the typical behavior of solitary intraductal papillomas?

Almost always remain benign Signup and view all the answers

How does the incidence of breast cancer vary geographically?

Significantly higher in North America and northern Europe Signup and view all the answers

Which factor is not typically correlated with breast cancer risk?

Height and weight at birth Signup and view all the answers

Study Notes

Non-Neoplastic Epithelial Disorders

Lichen Sclerosus:
- Characterized by atrophic epithelium and dermal fibrosis.
- Pathogenesis unclear; possible autoimmune involvement.
- Increased risk of squamous cell carcinoma.
Lichen Simplex Chronicus:
- Epithelial thickening resulting from inflammatory dermatoses.
- Expansion of stratum granulosum and surface hyperkeratosis noted.
- Typically no increased cancer risk; can appear at margins of vulvar cancers.

Tumors

Condylomas:
- Two types:
  - Condylomata lata: moist, flat lesions, associated with secondary syphilis.
  - Condylomata acuminata: more common, papillary, elevated lesions on anogenital surfaces.
- Not pre-cancerous, but found alongside low-grade vulvar intraepithelial neoplasia (VIN grade 1).

High-Grade Vulvar Intraepithelial Neoplasia and Carcinoma

Carcinoma of the vulva accounts for approximately 3% of all genital tract cancers in women.
90% of vulvar carcinomas are squamous cell carcinomas, primarily HPV-related, affecting younger patients.
Non-HPV-related cancers, typically arising in older women, associated with conditions like lichen sclerosus.

Cervicitis

Inflammation of the cervix commonly presents with purulent vaginal discharge.
Can result from infectious or non-infectious causes.
Frequently linked to sexually transmitted diseases, with Chlamydia trachomatis responsible for 40% of cases in STI clinics.

Cervical Cancer

Major cause of cancer mortality in women.
The pap smear is an effective screening tool for early detection.
Cervical intraepithelial neoplasia (CIN) can be identified years before invasive cancer develops, with peak CIN incidence around 30 years of age.

Proliferative Breast Disease

Without Atypia:
- Includes lesions such as epithelial hyperplasia, sclerosing adenosis, complex sclerosing lesions, and papillomas.
With Atypia:
- Includes atypical ductal hyperplasia and atypical lobular hyperplasia.

Breast Tumors

Can originate in either epithelial or connective tissue; most breast neoplasms arise from epithelial structures.
Fibroadenoma:
- Most common benign breast tumor, typically occurs in women around their third decade.
- Linked to increased estrogen activity, presents as discrete, movable masses.
Phyllodes Tumor:
- Less common than fibroadenomas, can be large and cystic, with possible malignant transformation.
Intraductal Papilloma:
- Neoplastic growth within ducts; can cause serous or bloody discharge and occasionally be associated with nipple retraction.

Breast Cancer Risk Factors

75% of breast cancer cases occur in women over age 50.
Geographic variation in incidence; higher rates in North America and northern Europe.
Family history and genetics play a significant role, with BRCA1 and BRCA2 mutations frequently implicated.
Prolonged exposure to estrogen from hormone replacement therapy (HRT) and oral contraceptives is associated with increased cancer risk.
Ionizing radiation exposure, obesity, alcohol, and high-fat diets also identified as risk factors.

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Description

This quiz covers non-neoplastic epithelial disorders such as Lichen Sclerosus and Lichen Simplex Chronicus, as well as various types of condylomas. It also addresses high-grade vulvar intraepithelial neoplasia and carcinoma, focusing on their characteristics and cancer risks. Test your knowledge of these important dermatological conditions.