FEMALE GENITAL SYSTEM: VAGINAL LESIONS
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DR. ROOPAM JAIN, Professor & Head, Department of Pathology & Blood Bank
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FEMALE GENITAL SYSTEM: VAGINAL LESIONS
- 1. FEMALE GENITAL SYSTEM – VAGINAL LESIONS DR. ROOPAM JAIN PROFESSOR & HEAD, DEPT. OF PATHOLOGY & BLOOD BANK
- 2. VAGINA
- 3. VAGINITIS & VULVOVAGINITIS • Since vulva and vagina are anatomically close to each other, often inflammation of one affects the other location. • i) Bacterial e.g. streptococci, staphylococci, Escherichia coli, Haemophilus vaginalis. • ii) Fungal e.g. Candida albicans. • iii) Protozoal e.g. Trichomonas vaginalis. • iv) Viral e.g. Herpes simplex.
- 4. VAGINITIS & VULVOVAGINITIS • The most common causes of vaginitis are Candida (moniliasis) and Trichomonas (trichomoniasis). • The hyphae of Candida can be seen in the vaginal smears. • Similarly, the protozoa, Trichomonas, can be identified in smears. • These infections are particularly common in pregnant and diabetic women and may involve both vulva and vagina. • (adult vaginal mucosa is relatively resistant to gonococcal infection because of its histology)
- 6. • Vaginal cysts such as Gartner’s duct (Wolffian) cyst lined by glandular epithelium and vaginal inclusion cyst arising from inclusion of vaginal epithelium are more common benign vaginal tumours • Other uncommon benign tumours are papillomas, fi bromas, lipomas, angiomas and leiomyomas • Primary malignancies of the vagina are rare • and include carcinoma (squamous cell carcinoma and adenocarcinoma) • and embryonal rhabdomyosarcoma (sarcoma botryoides).
- 7. CARCINOMA OF VAGINA • Primary carcinoma of the vagina is an uncommon tumour. • Squamous cell dysplasia or vaginal intra epithelial neoplasia occur less frequently as compared to the cervix or vulva and can be detected by Pap smears. • Invasive carcinoma of the vagina includes two main types: • 1. Squamous cell carcinoma of vagina constitutes less than 2% of all gynaecologic malignancies. The role of HPV types 16 and 18 in its etiology • 2. Adenocarcinoma of the vagina is much less frequent than squamous cell carcinoma of the vagina. It may be endometrioid or mucinous type.
- 8. FIGO clinical staging of carcinoma of the vagina
- 9. EMBRYONAL RHABDOMYOSARCOMA (SARCOMA BOTRYOIDES) • This is an unusual and rare malignant tumour occurring in infants and children • under 5 years of age. • The common location is anterior vaginal wall.
- 10. EMBRYONAL RHABDOMYOSARCOMA (SARCOMA BOTRYOIDES) MORPHOLOGIC FEATURES Grossly • The tumour is charac terised by bulky and polypoid grape-like mass (botryoides = grape) that fills and projects out of the vagina. Histologically: • 1. Groups of round to fusiform tumour cells are characteristically lying underneath the vaginal epithelium, called cambium layer of tumour cells. • 2. The central core of polypoid masses is composed of loose and myxoid stroma with many infl ammatory cells.