Vagina Pathoma PDF

# VAGINA ## I. BASIC PRINCIPLES - Canal leading to the cervix - Mucosa is lined by non-keratinizing squamous epithelium ## II. ADENOSIS - Focal persistence of columnar epithelium in the upper vagina. - During development, squamous epithelium from the lower 1/3 of the vagina (derived from the ur...

# VAGINA ## I. BASIC PRINCIPLES - Canal leading to the cervix - Mucosa is lined by non-keratinizing squamous epithelium ## II. ADENOSIS - Focal persistence of columnar epithelium in the upper vagina. - During development, squamous epithelium from the lower 1/3 of the vagina (derived from the urogenital sinus) grows upward to replace the columnar epithelium lining of the upper 2/3 of the vagina (derived from the Müllerian ducts). - Increased incidence in females who were exposed to diethylstilbestrol (DES) in utero. ## III. CLEAR CELL ADENOCARCINOMA - Malignant proliferation of glands with clear cytoplasm - Rare, but feared, complication of DES-associated vaginal adenosis - Discovery of this complication (along with other DES-induced abnormalities of the gynecologic tract such as abnormal shape of the uterus) led to cessation of DES usage. ## IV. EMBRYONAL RHABDOMYOSARCOMA - Malignant mesenchymal proliferation of immature skeletal muscle; rare - Presents as bleeding and a grape-like mass protruding from the vagina or penis of a child (usually < 5 yrs of age); also known as sarcoma botryoides. - Rhabdomyoblast, the characteristic cell, exhibits cytoplasmic cross-striations and positive immunohistochemical staining for desmin and myogenin. ## V. VAGINAL CARCINOMA - Carcinoma arising from squamous epithelium lining the vaginal mucosa - Usually related to high-risk HPV - Precursor lesion is vaginal intraepithelial neoplasia (VAIN). - When spread to regional lymph nodes occurs, cancer from the lower 1/3 of vagina goes to inguinal nodes, and cancer from the upper 2/3 goes to regional iliac nodes.