Herpes Vulvitis

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22/02/53 Clinical: * Pruritic red, crusted, sharply demarcated, maplike area, * Occurring usually on the labia majora. * Possible palpable submucosal thickening or tumor BUT….tumor cells often extend into skin appendages and may extend beyond the confines of the grossly visible lesion----- prone to recurrence. Prognosis is poor if associated with invasive cancer!! Paget disease as an intraepidermal lesion, may persist for many years without invasion. Clear halo, containing mucopolysaccharide (+ PAS, alcian blue, or mucicarmine stains) finely granular cytoplasm Single or small nests of large tumor cells in epidermis Ultrastructure: Paget cells display apocrine, eccrine, & keratinocyte differentiation Presumably arise from primitive epithelial progenitor cells. pale cytoplasm (stain for mucin, PAS-D stain, CEA, EMA) 1 o Paget dis. 2 o Paget dis. prominent nucleolus wide & deep surgical excision directed toward Rx of ass. CA large round to oval nuclei 40X 14
22/02/53 DDx of vulvar intraepithelial Pagetoid cells • 1 o Paget Disease Usually requires IHC to distinguish • 2 o Paget disease • Vulva intraepithelial neoplasia • Superficial spreading melanoma • Pagetoid Spitz nevus • Sebaceous carcinoma • Merkel cell carcinoma • Clear cell papulosis (related to Toker cells) • Cutaneous T-cell lymphoma • Histiocytosis X • Langerhans’ cell microabscess • Benign mucinous metaplasia of vulva IHC findings of Paget disease Type CK-7 CK-20 GCDFP-15 CEA UP- III 1 O skin + - + + (most) - 1 O anorectal CA (+) + - + (>90%) - 1 O urothelial CA + (+) - + (67%) + (50-60%) CK, cytokeratin; CEA, carcinoembryonic antigen; GCDFP, gross cystic disease fluid protein; UP, uroplakin Brown & Wilkinson. Hum Pathol 2002;33:545-8. Tumor of vagina • Epithelial tumor Tumor of vagina • Mesenchymal tumor • Mixed epithelial and mesenchymal tumor • Melanocytic tumor • Miscellaneous tumor Epithelial tumor • Squamous tumor : – squamous cell carcinoma : keratinizing, nonkeratinizing, basaloid, verrucous, warty – Squamous intraepithelial neoplasia : VAIN – Benign squamous lesions : Condyloma acuminata, squamous papilloma (vaginal micropapillomatosis), fibroepithelial polyp Epithelial tumor • Glandular tumor – Clear cell adenocarcinoma – Endometrioid adenocarcinoma Mucinous adenocarcinoma – Mucinous adenocarcinoma – Mesonephric adenocarcinoma – Malignant papilloma – Adenoma : tubular, tubulovillous, villous 15
Page 1 and 2: 22/02/53 Clitoral hood Perineum Ra
Page 3 and 4: 22/02/53 may express in 3 forms 1.
Page 5 and 6: 22/02/53 hyperkeratosis... thickene
Page 7 and 8: 22/02/53 VIN: type of lesion (N=73)
Page 9 and 10: 22/02/53 Cases should be classifie
Page 11 and 12: 22/02/53 • Uncommon variant of SC
Page 13: 22/02/53 * 1 st described in 1888,
Page 17 and 18: 22/02/53 Vaginal intraepithelial ne
Page 19 and 20: 22/02/53 Postoperative Spindle Cell
Page 21: 22/02/53 Aggressive angiomyxoma •

Herpes Vulvitis

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