13.1 - Vulva

Question 1

the vulva is lined by ______________

Answer 1

squamous epithelium

Question 2

unilateral, painful cystic lesion at the lower vestibule adjacent to the vaginal canal - diagnosis?

Answer 2

bartholin cyst

Question 3

condyloma is due to which strains of HPV?

Answer 3

6 and 11

Question 4

what is the histologic hallmark feature of condloma?

Answer 4

koilocytes

Question 5

what are the high risk strains of HPV that can progress to carcinoma?

Answer 5

16, 18, 31, 33

Question 6

what is lichen sclerosis? how does it present?

Answer 6

• thinning of the epidermis and fibrosis (sclerosis) of the dermis
• white patch (leukoplakia) with “parchment-like” vulvar skin

Question 7

white patch (leukoplakia) with “parchment-like” vulvar skin - diagnosis?

Answer 7

lichen sclerosis

Question 8

what is lichen simplex chronicus? what is the presentation?

Answer 8

• hyperplasia of the vulvar squamous epithelium
• leukoplakia with thick, leathery vulvar skin
• chronic irritation and scratching

Question 9

• leukoplakia with thick, leathery vulvar skin
• chronic irritation and scratching

diagnosis?

Answer 9

lichen simplex chronicus

Question 10

HPV related vulvar carcinoma is due to which HPV strains?

Answer 10

16 and 18

Question 11

non HPV related vulvar carcinoma arises most often from what condition?

Answer 11

long standing lichen sclerosis

Question 12

what is the defining feature of extramammary paget disease?

Answer 12

malignant epithelial cells in the epidermis of the vulva

Question 13

how does extramammary paget disease present?

Answer 13

erythematous, pruritic, ulcerated vulvar skin

Question 14

is there an underlying carcinoma in extramammary paget disease?

Answer 14

NO**

there is in paget disease of the breast, however

Question 15

how can extramammary paget disease be distinguished from melanoma?

Answer 15

paget cells are:

• PAS positive**
• keratin positive**
• S100 positive

melanoma cells are:

• PAS negative**
• keratin negative**
• S100 positive

Question 16

how do paget cells stain for:

• PAS
• keratin
• S100

Answer 16

• PAS positive**
• keratin positive**
• S100 positive

Question 17

how do melanoma cells stain for:

• PAS
• keratin
• S100

Answer 17

• PAS negative**
• keratin negative**
• S100 positive