Vagina and Related Conditions

Vagina

• Basic Principles:
  • The canal leading to the cervix is lined by non-keratinizing squamous epithelium.
  • The vaginal mucosa is covered by non-keratinizing squamous epithelium.

Adenosis

• Focal Persistence of Columnar Epithelium:
  • During vaginal development, squamous epithelium from the lower third replaces columnar epithelium in the upper two-thirds.
  • The lower third arises from the urogenital sinus, while the upper two-thirds originate from the Müllerian ducts.
  • Exposure to diethylstilbestrol (DES) in utero increases the risk of adenosis.

Clear Cell Adenocarcinoma

• Malignant Proliferation:
  • Characterized by a malignant proliferation of glands with clear cytoplasm.
  • A rare but serious complication of DES-associated vaginal adenosis.

Embryonal Rhabdomyosarcoma

• Malignant Mesenchymal Proliferation:
  • A rare malignant tumor arising from immature skeletal muscle tissue.
  • Often presents as bleeding and a grape-like mass protruding from the vagina or penis, usually in children under 5 years of age (also known as sarcoma botryoides).
  • The characteristic cells, rhabdomyoblasts, display cytoplasmic cross-striations and positive immunohistochemical staining for desmin and myogenin.
  • The diagnosis of this condition, along with other DES-related issues, led to the cessation of DES usage.

Vaginal Carcinoma

• Origin from Squamous Epithelium:
  • Arises from the squamous epithelium that lines the vaginal mucosa.
  • Usually linked to high-risk HPV (Human Papillomavirus).
  • Vaginal intraepithelial neoplasia (VAIN) is a precursor lesion.
  • When cancer spreads to the lymph nodes, the lower one-third of the vagina spreads to inguinal nodes, while the upper two-thirds spreads to regional iliac nodes.

Explore the anatomy and pathology of the vagina, including the basic principles of vaginal epithelium, adenosis, and related malignancies such as clear cell adenocarcinoma and embryonal rhabdomyosarcoma. This quiz will deepen your understanding of these conditions and their implications.