Pathology Atlas: Vulva Michael John Hughey |
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Michael John Hughey, MD |
Condyloma |
Fig. 3. Condylomata showing acanthosis, parakeratosis and koilocytotic changes. Volume 1, Chapter 9 |
Vulvar Intraepithelial Neoplasia (VIN) |
Fig. 2. Vulvar intraepithelial neoplasia (VIN) 3, multifocal. Note raised pale lesions on outer minora and across fourchette. Volume 4, Chapter 40 |
Fig. 1. VIN III. Note large irregular nuclei, loss of differentiation, and overlying hyperkeratosis (black arrow). Volume 4, Chapter 42 |
Paget Disease |
Fig. 5. Primary Paget disease (type 1). Note irregular patchy change present on lateral aspect of labium majus. Volume 4, Chapter 40 |
Fig. 6. Primary Paget disease (type 1). Characteristic large, pale Paget cells are just above basal layer (magnification, ×500). Volume 4, Chapter 40 |
Squamous Cell Carcinoma |
Fig. 8. Superficially invasive squamous cell carcinoma with vulvar intraepithelial neoplasia (VIN) 3. There is a marked inflammatory response. |
Fig. 10. Well-differentiated squamous carcinoma. Large cells with abundant cytoplasm form keratin pearls (magnification, ×80). |
Fig. 11. Poorly differentiated squamous cell carcinoma of the vulva. The tumor cells are nonkeratinized, without prominent intercellular bridges. The tumor has a “finger-like” pattern of invasion. |
Fig. 12. Adenoid-squamous pattern with pseudoglandular spaces lined by squamous cells (magnification, ×500). |
Fig. 13. Squamous cell carcinoma, warty or condylomatous type. The epithelium shows little cellular atypia and the tumor-dermal interface is infiltrative rather than pushing in appearance. |
Basal Cell Carcinoma |
Fig. 14. Basal cell carcinoma. The tumor is composed of small, uniform hyperchromatic cells with peripheral palisading of the nuclei. Central necrosis is present focally. |
Melanoma |
Fig. 15. Malignant melanoma. Large nevoid cells with prominent nucleoli extend down from dermoepidermal junction. Some contain pigment (magnification, ×400). |
Leiomyosarcoma |
Fig. 16. Leiomyosarcoma of the vulva. The tumor is composed of fascicles of smooth muscle with nuclear atypia, characterized by enlarged, irregular, and hyperchromatic nuclei. |
Histiocytoma |
Fig. 17. Fibrous histiocytoma. Spindle-shaped cells with elongated nuclei form swirling patterns (magnification, ×400). |
Carcinoma in situ |
Fig. 5. Carcinoma in situ showing epithelial atypia throughout the epithelial layer. Volume 1, Chapter 9 |
Hidradenoma |
Fig. 7. Hidradenoma of the vulva ( × 25) Volume 1, Chapter 9 |
Syringoma |
Fig. 8 . Syringoma Numerous dilated sweat gland ducts are seen ( × 35). Volume 1, Chapter 9 |
Nevi |
Fig. 9. Intradermal nevus. Nevus cells are seen in the upper dermis ( × 40) Volume 1, Chapter 9 |
Fig. 10. Junctional nevus. This type may become malignant ( × 50) Volume 1, Chapter 9 |
Fig. 11. Compound nevus. Nevus cells are seen at the junction of the epidermis and dermis and in the upper dermis (× 50) Volume 1, Chapter 9 |
Fibroma |
Fig. 13. Fibroma. Coarse bundles of fibroblasts and fibrocytes are seen ( × 65) Volume 1, Chapter 9. |
Neurofibroma |
Fig. 14. Neurofibroma. Spindle cells with angulated nuclei are seen ( × 50) Volume 1, Chapter 9. |
Granular cell tumor |
Lymphangioma |
Fig. 16. Lymphangioma with many dilated lymphatic channels ( × 90) Volume 1, Chapter 9. |