Disorders of the Cervix, Vagina, and Vulva – Key Vocabulary

A set of vocabulary flashcards summarizing the essential terms, lesions, pathogens, and risk factors discussed in the lecture on disorders of the cervix, vagina, and vulva.

Cervix

The lower, narrow portion of the uterus that opens into the vagina and is lined by both squamous (exocervix) and columnar (endocervix) epithelium.

Transformation Zone

Area of the cervix where columnar epithelium of the endocervix is replaced by squamous epithelium; most common site for HPV infection and cervical dysplasia.

Squamocolumnar Junction (SCJ)

Histologic border between squamous epithelium of the ectocervix and columnar epithelium of the endocervix; migrates with age and hormonal status.

Ectropion

Physiologic eversion of endocervical columnar epithelium onto the ectocervix, commonly seen in adolescents and pregnancy.

Cervical Metaplasia

Replacement of columnar epithelium by squamous epithelium in the transformation zone, often driven by acidic vaginal environment.

Pap Smear

Cytologic test that scrapes cells from the cervix to screen for HPV infection, dysplasia, and carcinoma.

ThinPrep

Liquid-based cytology method for Pap testing that improves cell preservation and reduces obscuring material.

Koilocyte

Squamous epithelial cell with perinuclear clearing and irregular, hyperchromatic nucleus; hallmark of HPV infection.

Human Papillomavirus (HPV)

DNA virus infecting squamous epithelium; certain types cause condylomas, dysplasia, and cancers of the cervix, vulva, anus, and oropharynx.

Low-Risk HPV Types

HPV strains 6, 11 (and 42, 44, 53, 54, 62, 66) that cause condyloma acuminatum and low-grade lesions but rarely lead to cancer.

High-Risk HPV Types

HPV strains 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 68 strongly associated with high-grade dysplasia and cervical carcinoma.

Low-Grade Squamous Intraepithelial Lesion (LSIL)

Bethesda term for mild abnormalities (HPV infection/CIN I) confined to lower third of epithelium.

High-Grade Squamous Intraepithelial Lesion (HSIL)

Bethesda term encompassing CIN II and CIN III; marked atypia extending beyond lower third of epithelium.

CIN I

Mild cervical intraepithelial neoplasia limited to lower third of squamous epithelium; equivalent to LSIL.

CIN II

Moderate dysplasia involving up to two-thirds of epithelial thickness; part of HSIL.

CIN III

Severe dysplasia or carcinoma in situ involving full epithelial thickness; part of HSIL.

Colposcopy

Magnified examination of the cervix and vagina using a colposcope, often combined with targeted biopsies.

Indications for Colposcopy

Abnormal Pap (ASC-US with HPV+, LSIL, HSIL), abnormal-appearing cervix, repeated unexplained inflammation, or history of in-utero DES exposure.

HPV E6 Protein

Viral oncoprotein that binds and promotes degradation of p53, impairing apoptosis.

HPV E7 Protein

Viral oncoprotein that binds RB, releasing E2F, up-regulating Cyclin E and p16, and driving cell cycle progression.

Cervical Dysplasia

Spectrum of premalignant epithelial changes (CIN I–III/LSIL–HSIL) characterized by koilocytosis, atypia, and disordered maturation.

Risk Factors for Cervical Carcinoma

Early sexual activity, multiple partners, high-risk male partner, persistent high-risk HPV, high parity, oral contraceptives, smoking, Chlamydia infection, certain HLA types, and immunosuppression.

Microinvasive Squamous Cell Carcinoma

Early invasive cervical cancer with stromal invasion ≤ 3 mm beneath basement membrane.

Invasive Squamous Cell Carcinoma

Malignant squamous tumor that penetrates cervical stroma beyond microinvasive criteria, may metastasize.

Cervical Adenocarcinoma

Malignant tumor of endocervical glandular epithelium; also linked to high-risk HPV (especially types 16, 18, 45).

Vaginal Adenosis

Persistence of columnar epithelium in upper vagina; red granular lesions; associated with in-utero DES exposure and risk of clear cell carcinoma.

Clear Cell Adenocarcinoma

Malignant glandular tumor with clear cytoplasm and hobnail cells, typically in upper vagina or cervix of young women exposed to DES prenatally.

Diethylstilbestrol (DES)

Synthetic estrogen once used to prevent miscarriage; in-utero exposure leads to vaginal adenosis, clear cell carcinoma, and cervical abnormalities.

Condyloma Acuminatum

Warty neoplasm of anogenital skin/mucosa caused mainly by low-risk HPV 6, 11; histology shows koilocytosis, acanthosis, hyperkeratosis.

Vulvar Intraepithelial Neoplasia (VIN)

Precursor dysplastic lesion of vulvar squamous epithelium, often HPV 16/18-related, characterized by koilocytosis and atypia.

Type 1 Vulvar Squamous Cell Carcinoma

HPV-related (≥ 60%), basaloid/poorly differentiated, occurs in younger women with VIN, smoking, and STD history.

Type 2 Vulvar Squamous Cell Carcinoma

Non-HPV, keratinizing, well differentiated, arises in older women with lichen sclerosus or chronic inflammation.

Extramammary Paget Disease (Vulva)

Intraepidermal adenocarcinoma presenting as red, pruritic, crusted lesion of vulvar skin; Paget cells are PAS +, cytokeratin +, S100 –; usually no underlying carcinoma.

Bartholin Gland Cyst

Obstruction and inflammation of Bartholin duct causing painful, tender cystic swelling on posterolateral vulva.

Sarcoma Botryoides (Embryonal Rhabdomyosarcoma)

Polypoid grape-like malignant tumor of vagina (infants/children) composed of rhabdomyoblasts; presents with bleeding mass.

Chlamydia trachomatis Cervical Infection

Common sexually transmitted infection that may appear on Pap smear; coinfection increases risk of cervical dysplasia and infertility.