Benign Glandular Lesions, Pathology of the Vagina

In: Encyclopedia of Pathology · 2022 · pp. 1–3 · doi:10.1007/978-3-319-28845-1_5594-1 · W4322752087
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This entry describes endometriosis, a condition defined by endometrial stroma in the vagina, presenting clinically with bleeding, pain, or masses, and microscopically with endometrial glands and stroma.

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This encyclopedia-style pathology chapter reviews benign glandular lesions of the vagina, focusing on endometriosis as a condition defined by endometrial stroma with or without glands, and briefly contrasting clinical features of superficial versus deep vaginal endometriosis. It summarizes that superficial endometriosis may cause vaginal bleeding, while deep endometriosis more often presents with pelvic endometriosis–associated pain, dyspareunia, and sometimes pressure symptoms, with polypoid vaginal masses described as rare and predominantly in the upper vagina/posterior wall. The chapter characterizes macroscopic findings as polypoid and/or hemorrhagic pink or tan masses, and microscopic findings as endometrial-type glands and/or stroma, noting that lesions in pregnant women or hormone-treated cases may show stromal decidualization; however, the overall caveat is that it is a general pathology overview rather than original research. Relevance to endometriosis: The paper’s content is centrally about endometriosis of the vagina, including definitions, clinical presentations, and histopathology of superficial and deep vaginal endometriosis.

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Endometriosis Definition The presence of endometrial stroma with or without glands. Clinical Features Superficial endometriosis may present with vaginal bleeding. Deep endometriosis, associated with pelvic endometriosis, presents with pain, dyspareunia, and sometimes pressure symptoms. Rarely, polypoid vaginal masses may be seen (Parker et al., 2004). - Incidence Deep vaginal endometriosis is more common. - Age Most women present premenopausally. - Site The upper half of the vagina is the common location. Polypoid endometriosis presents in the posterior wall. - Treatment Treatment with hormones or excision of the lesion is the initial treatment. Deep endometriosis may require complex surgery (Angioli et al., 2014). - Macroscopy Tissue may appear polypoid and/or hemorrhagic. They may also present as polypoid, pink, or tan-colored masses. - Microscopy Endometrial-type glands and/or stroma are seen. Lesions in pregnant women or in hormone-treated cases may show stromal decidualization. - ... References and Further Reading Angioli, R., De Cicco Nardone, C., Cafà, E. V., Plotti, F., Muzii, L., Montera, R., Guzzo, F., Luvero, D., & Terranova, C. (2014). Surgical treatment of rectovaginal endometriosis with extensive vaginal infiltration: Results of a systematic three-step vagino-laparoscopic approach. European Journal of Obstetrics & Gynecology and Reproductive Biology, 173, 83–87. Cebesoy, F. B., Kutlar, I., & Aydin, A. (2007). Vaginal adenosis successfully treated with simple unipolar cauterization. Journal of National Medical Association, 99(2), 166–167. Han, T., Jin, Y., Li, Y., Bi, Y., & Pan, L. (2018). Clinicopathologic features and outcomes of primary vaginal adenosis as a dermatologic and gynecologic burden: A retrospective study. Medicine (Baltimore), 97(49), e13470. Herbst, A. L., Poskanzer, D. C., Robboy, S. J., Friedlander, L., & Scully, R. E. (1975). Prenatal exposure to stilbestrol. A prospective comparison of exposed female offspring with unexposed controls. New England Journal of Medicine, 292(7), 334–339. Parker, R. L., Dadmanesh, F., Young, R. H., & Clement, P. B. (2004). Polypoid endometriosis: A clinicopathologic analysis of 24 cases and a review of the literature. American Journal of Surgical Pathology, 28(3), 285–297. Robboy, S. J., Szyfelbein, W. M., Goellner, J. R., Kaufman, R. H., Taft, P. D., Richard, R. M., Gaffey, T. A., Prat, J., Virata, R., Hatab, P. A., McGorray, S. P., Noller, K. L., Townsend, D., Labarthe, D., & Barnes, A. B. (1981). Dysplasia and cytologic findings in 4,589 young women enrolled in diethylstilbestrol-adenosis (DESAD) project. American Journal of Obstetrics and Gynecology, 140(5), 579–586. Wong, R. W., Moore, M., Talia, K. L., Ganesan, R., & McCluggage, W. G. (2018). Primary vaginal gastric-type adenocarcinoma and vaginal Adenosis exhibiting gastric differentiation: Report of a series with detailed Immunohistochemical analysis. American Journal of Surgical Pathology, 42(7), 958–970. Author information Authors and Affiliations Corresponding author Editor information Editors and Affiliations Rights and permissions Copyright information © 2022 Springer Nature Switzerland AG About this entry Cite this entry Ganesan, R. (2022). Benign Glandular Lesions, Pathology of the Vagina. In: van Krieken, J. (eds) Encyclopedia of Pathology. Encyclopedia of Pathology. Springer, Cham. https://doi.org/10.1007/978-3-319-28845-1_5594-1 Download citation DOI: https://doi.org/10.1007/978-3-319-28845-1_5594-1 Received: Accepted: Published: Publisher Name: Springer, Cham Print ISBN: 978-3-319-28845-1 Online ISBN: 978-3-319-28845-1 eBook Packages: Living Reference MedicineReference Module Medicine

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