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Benign Lesions of the Vagina

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Gynecologic and Obstetric Pathology, Volume 1

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Abstract

This chapter describes the normal anatomy, histology and microflora of the vagina and a selection of benign vaginal diseases, including inflammatory and other disorders, with an emphasis on their etiopathogenesis and morphological features that may be necessary to achieve their correct diagnoses. Pathologic differential diagnosis is described in detail, especially in entities which can be confused with some premalignant or malignant diseases, such as malacoplakia, vaginal cysts and tumour-like lesions including fibroepithelial polyps, tubulosquamous polyps, postoperative spindle cell nodules and prolapsed fallopian tube. A discussion of vaginal adenosis is also included, including its historical perspective.

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References

  1. Weber AM, Walters MD, Schover LR, Mitchinson A. Vaginal anatomy and sexual function. Obstet Gynecol. 1995;86(6):946–9.

    Article  CAS  PubMed  Google Scholar 

  2. Levin RJ. Sex and the human female reproductive tract--what really happens during and after coitus. Int J Impot Res. 1998;10(Suppl 1):S14–21.

    PubMed  Google Scholar 

  3. Hodgins MB, Spike RC, Mackie RM, MacLean AB. An immunohistochemical study of androgen, oestrogen and progesterone receptors in the vulva and vagina. Br J Obstet Gynaecol. 1998;105(2):216–22.

    Article  CAS  PubMed  Google Scholar 

  4. Miyagawa S, Iguchi T. Epithelial estrogen receptor 1 intrinsically mediates squamous differentiation in the mouse vagina. Proc Natl Acad Sci U S A. 2015;112(42):12986–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Blakeman PJ, Hilton P, Bulmer JN. Cellular proliferation in the female lower urinary tract with reference to oestrogen status. BJOG. 2001;108(8):813–6.

    CAS  PubMed  Google Scholar 

  6. Bachmann GA, Nevadunsky NS. Diagnosis and treatment of atrophic vaginitis. Am Fam Physician. 2000;61(10):3090–6.

    CAS  PubMed  Google Scholar 

  7. Simon JA. Identifying and treating sexual dysfunction in postmenopausal women: the role of estrogen. J Womens Health (Larchmt). 2011;20(10):1453–65.

    Article  Google Scholar 

  8. Kurman RJ. Blaustein’s pathology of the female genital tract. New York: Springer; 2011.

    Book  Google Scholar 

  9. Miller EA, Beasley DE, Dunn RR, Archie EA. Lactobacilli dominance and vaginal pH: why is the human vaginal microbiome unique? Front Microbiol. 2016;7:1936.

    PubMed  PubMed Central  Google Scholar 

  10. Fettweis JM, Serrano MG, Girerd PH, Jefferson KK, Buck GA. A new era of the vaginal microbiome: advances using next-generation sequencing. Chem Biodivers. 2012;9(5):965–76.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Kovachev S. Defence factors of vaginal lactobacilli. Crit Rev Microbiol. 2018;44(1):31–9.

    Article  CAS  PubMed  Google Scholar 

  12. Kurman RJ, Hedrick Ellenson L, Ronnett BM. Blaustein’s pathology of the female genital tract. 6th ed. New York: Springer; 2011. p. 1246.

    Book  Google Scholar 

  13. Bertuccini L, Russo R, Iosi F, Superti F. Effects of Lactobacillus rhamnosus and Lactobacillus acidophilus on bacterial vaginal pathogens. Int J Immunopathol Pharmacol. 2017;30(2):163–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Nwankwo TO, Aniebue UU, Umeh UA. Syndromic diagnosis in evaluation of women with symptoms of vaginitis. Curr Infect Dis Rep. 2017;19(1):3.

    Article  PubMed  Google Scholar 

  15. Mills BB. Vaginitis: beyond the basics. Obstet Gynecol Clin N Am. 2017;44(2):159–77.

    Article  Google Scholar 

  16. Cauci S, Driussi S, De Santo D, Penacchioni P, Iannicelli T, Lanzafame P, et al. Prevalence of bacterial vaginosis and vaginal flora changes in peri- and postmenopausal women. J Clin Microbiol. 2002;40(6):2147–52.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Cauci S, Monte R, Driussi S, Lanzafame P, Quadrifoglio F. Impairment of the mucosal immune system: IgA and IgM cleavage detected in vaginal washings of a subgroup of patients with bacterial vaginosis. J Infect Dis. 1998;178(6):1698–706.

    Article  CAS  PubMed  Google Scholar 

  18. Gravett MG, Nelson HP, DeRouen T, Critchlow C, Eschenbach DA, Holmes KK. Independent associations of bacterial vaginosis and Chlamydia trachomatis infection with adverse pregnancy outcome. JAMA. 1986;256(14):1899–903.

    Article  CAS  PubMed  Google Scholar 

  19. Hillier SL, Nugent RP, Eschenbach DA, Krohn MA, Gibbs RS, Martin DH, et al. Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. The Vaginal Infections and Prematurity Study Group. N Engl J Med. 1995;333(26):1737–42.

    Article  CAS  PubMed  Google Scholar 

  20. Morris M, Nicoll A, Simms I, Wilson J, Catchpole M. Bacterial vaginosis: a public health review. BJOG. 2001;108(5):439–50.

    CAS  PubMed  Google Scholar 

  21. Gillet E, Meys JF, Verstraelen H, Verhelst R, De Sutter P, Temmerman M, et al. Association between bacterial vaginosis and cervical intraepithelial neoplasia: systematic review and meta-analysis. PLoS One. 2012;7(10):e45201.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Nucci MR, Oliva E. In: Goldblum JR, editor. Gynecologic pathology, vol. 592. 1st ed. Spain: Churchill Livingstone; 2009.

    Google Scholar 

  23. Bitew A, Abebaw Y, Bekele D, Mihret A. Prevalence of bacterial vaginosis and associated risk factors among women complaining of genital tract infection. Int J Microbiol. 2017;2017:4919404.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  24. Gaydos CA, Beqaj S, Schwebke JR, Lebed J, Smith B, Davis TE, et al. Clinical validation of a test for the diagnosis of vaginitis. Obstet Gynecol. 2017;130(1):181–9.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Amsel R, Totten PA, Spiegel CA, Chen KC, Eschenbach D, Holmes KK. Nonspecific vaginitis. Diagnostic criteria and microbial and epidemiologic associations. Am J Med. 1983;74(1):14–22.

    Article  CAS  PubMed  Google Scholar 

  26. Nugent RP, Krohn MA, Hillier SL. Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation. J Clin Microbiol. 1991;29(2):297–301.

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Sodhani P, Garg S, Bhalla P, Singh MM, Sharma S, Gupta S. Prevalence of bacterial vaginosis in a community setting and role of the pap smear in its detection. Acta Cytol. 2005;49(6):634–8.

    Article  PubMed  Google Scholar 

  28. Sodhani P, Gupta S, Gupta R, Mehrotra R. Bacterial vaginosis and cervical intraepithelial neoplasia: is there an association or is co-existence incidental? Asian Pac J Cancer Prev. 2017;18(5):1289–92.

    PubMed  PubMed Central  Google Scholar 

  29. Donders GGG, Bellen G, Grinceviciene S, Ruban K, Vieira-Baptista P. Aerobic vaginitis: no longer a stranger. Res Microbiol. 2017;168(9–10):845–58.

    Article  PubMed  Google Scholar 

  30. Donders G, Bellen G, Rezeberga D. Aerobic vaginitis in pregnancy. BJOG. 2011;118(10):1163–70.

    Article  PubMed  Google Scholar 

  31. Rumyantseva TA, Bellen G, Savochkina YA, Guschin AE, Donders GG. Diagnosis of aerobic vaginitis by quantitative real-time PCR. Arch Gynecol Obstet. 2016;294(1):109–14.

    Article  CAS  PubMed  Google Scholar 

  32. Geng N, Wu W, Fan A, Han C, Wang C, Wang Y, et al. Analysis of the risk factors for aerobic vaginitis: a case-control study. Gynecol Obstet Investig. 2016;81:148–54.

    Article  Google Scholar 

  33. Han C, Wu W, Fan A, Wang Y, Zhang H, Chu Z, et al. Diagnostic and therapeutic advancements for aerobic vaginitis. Arch Gynecol Obstet. 2015;291(2):251–7.

    Article  PubMed  Google Scholar 

  34. Fan A, Yue Y, Geng N, Zhang H, Wang Y, Xue F. Aerobic vaginitis and mixed infections: comparison of clinical and laboratory findings. Arch Gynecol Obstet. 2013;287(2):329–35.

    Article  PubMed  Google Scholar 

  35. Jahic M, Mulavdic M, Nurkic J, Jahic E, Nurkic M. Clinical characteristics of aerobic vaginitis and its association to vaginal candidiasis, trichomonas vaginitis and bacterial vaginosis. Med Arch. 2013;67(6):428–30.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Sonnex C. Genital streptococcal infection in non-pregnant women: a case-note review. Int J STD AIDS. 2013;24(6):447–8.

    Article  CAS  PubMed  Google Scholar 

  37. Regan JA, Klebanoff MA, Nugent RP, Eschenbach DA, Blackwelder WC, Lou Y, et al. Colonization with group B streptococci in pregnancy and adverse outcome. VIP Study Group. Am J Obstet Gynecol. 1996;174(4):1354–60.

    Article  CAS  PubMed  Google Scholar 

  38. Leclair CM, Hart AE, Goetsch MF, Carpentier H, Jensen JT. Group B streptococcus: prevalence in a non-obstetric population. J Low Genit Tract Dis. 2010;14(3):162–6.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Savini V, Marrollo R, D'Antonio M, D'Amario C, Fazii P, D'Antonio D. Streptococcus agalactiae vaginitis: nonhemolytic variant on the Liofilchem(R) Chromatic StreptoB. Int J Clin Exp Pathol. 2013;6(8):1693–5.

    PubMed  PubMed Central  Google Scholar 

  40. Verkaeren E, Epelboin L, Epelboin S, Boddaert N, Brossier F, Caumes E. Recurrent Streptococcus pyogenes genital infection in a woman: test and treat the partner! Int J Infect Dis. 2014;29:37–9.

    Article  PubMed  Google Scholar 

  41. Verstraelen H, Verhelst R, Vaneechoutte M, Temmerman M. Group A streptococcal vaginitis: an unrecognized cause of vaginal symptoms in adult women. Arch Gynecol Obstet. 2011;284(1):95–8.

    Article  PubMed  Google Scholar 

  42. Meltzer MC, Schwebke JR. Lactational amenorrhea as a risk factor for group a streptococcal vaginitis. Clin Infect Dis. 2008;46(10):e112–5.

    Article  PubMed  Google Scholar 

  43. Chua WC, Mazlan MZ, Ali S, Che Omar S, Wan Hassan WMN, Seevaunnantum SP, et al. Post-partum streptococcal toxic shock syndrome associated with necrotizing fasciitis. IDCases. 2017;9:91–4.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Shalaby T, Anandappa S, Pocock NJ, Keough A, Turner A. Lesson of the month 2: toxic shock syndrome. Clin Med (Lond). 2014;14(3):316–8.

    Article  Google Scholar 

  45. Schlievert PM, Nemeth KA, Davis CC, Peterson ML, Jones BE. Staphylococcus aureus exotoxins are present in vivo in tampons. Clin Vaccine Immunol. 2010;17(5):722–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. MacPhee RA, Miller WL, Gloor GB, McCormick JK, Hammond JA, Burton JP, et al. Influence of the vaginal microbiota on toxic shock syndrome toxin 1 production by Staphylococcus aureus. Appl Environ Microbiol. 2013;79(6):1835–42.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Vostral SL. Rely and toxic shock syndrome: a technological health crisis. Yale J Biol Med. 2011;84(4):447–59.

    PubMed  PubMed Central  Google Scholar 

  48. Bhagat N, Karthikeyan A, Kalkur S. Toxic shock syndrome within 24 H of an office hysteroscopy. J Midlife Health. 2017;8(2):92–4.

    PubMed  PubMed Central  Google Scholar 

  49. McDermott C, Sheridan M. Staphylococcal toxic shock syndrome caused by tampon use. Case Rep Crit Care. 2015;2015:640373.

    PubMed  PubMed Central  Google Scholar 

  50. Ameen F, Moslem M, Al Tami M, Al-Ajlan H, Al-Qahtani N. Identification of Candida species in vaginal flora using conventional and molecular methods. J Mycol Med. 2017;27(3):364–8.

    Article  CAS  PubMed  Google Scholar 

  51. Kalaiarasan K, Singh R, Chaturvedula L. Fungal profile of vulvovaginal Candidiasis in a Tertiary Care Hospital. J Clin Diagn Res. 2017;11(3):DC06–DC9.

    PubMed  PubMed Central  Google Scholar 

  52. Mtibaa L, Fakhfakh N, Kallel A, Belhadj S, Belhaj Salah N, Bada N, et al. Vulvovaginal candidiasis: etiology, symptomatology and risk factors. J Mycol Med. 2017;27(2):153–8.

    Article  CAS  PubMed  Google Scholar 

  53. Nakamura-Vasconcelos SS, Fiorini A, Zanni PD, Bonfim-Mendonca PS, Godoy JR, Almeida-Apolonio AA, et al. Emergence of Candida glabrata in vulvovaginal candidiasis should be attributed to selective pressure or virulence ability? Arch Gynecol Obstet. 2017;296(3):519–26.

    Article  CAS  PubMed  Google Scholar 

  54. Mandelblat M, Frenkel M, Abbey D, Ben Ami R, Berman J, Segal E. Phenotypic and genotypic characteristics of Candida albicans isolates from bloodstream and mucosal infections. Mycoses. 2017;60(8):534–45.

    Article  CAS  PubMed  Google Scholar 

  55. Matheson A, Mazza D. Recurrent vulvovaginal candidiasis: a review of guideline recommendations. Aust N Z J Obstet Gynaecol. 2017;57(2):139–45.

    Article  PubMed  Google Scholar 

  56. Cauchie M, Desmet S, Lagrou K. Candida and its dual lifestyle as a commensal and a pathogen. Res Microbiol. 2017;168(9–10):802–10.

    Article  PubMed  Google Scholar 

  57. Yano J, Noverr MC, Fidel PL Jr. Vaginal heparan sulfate linked to neutrophil dysfunction in the acute inflammatory response associated with experimental vulvovaginal candidiasis. MBio. 2017;8:2.

    Google Scholar 

  58. Asia AJ, Tapre VN. Primary actinomycosis of vulva with inguinal lymphadenopathy. Indian Dermatol Online J. 2016;7(5):402–5.

    Article  PubMed  PubMed Central  Google Scholar 

  59. Hagiya H, Ogawa H, Takahashi Y, Kimura K, Hasegawa K, Otsuka F. Actinomyces turicensis bacteremia secondary to pyometra. Intern Med. 2015;54(21):2775–7.

    Article  CAS  PubMed  Google Scholar 

  60. Khodavaisy S, Zibafar E, Hashemi SJ, Narenji H, Daie Ghazvini R. Actinomycosis in Iran: short narrative review article. Iran J Public Health. 2014;43(5):556–60.

    PubMed  PubMed Central  Google Scholar 

  61. Arora BB, Maheshwari M, Devgan N, Arora DR. Prevalence of trichomoniasis, vaginal candidiasis, genital herpes, chlamydiasis, and actinomycosis among urban and rural women of Haryana, India. J Sex Transm Dis. 2014;2014:963812.

    PubMed  PubMed Central  Google Scholar 

  62. Mutter GL, Prat J. Pathology of the female reproductive tract. 3rd ed. Spain: Churchill Livingstone; 2014. p. 904.

    Google Scholar 

  63. Yilmaz M, Akbulut S, Samdanci ET, Yilmaz S. Abdominopelvic actinomycosis associated with an intrauterine device and presenting with a rectal mass and hydronephrosis: a troublesome condition for the clinician. Int Surg. 2012;97(3):254–9.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Westhoff C. IUDs and colonization or infection with Actinomyces. Contraception. 2007;75(6 Suppl):S48–50.

    Article  PubMed  Google Scholar 

  65. Clement PB, Young RH. Atlas of gynecologic surgical pathology. 3rd ed. Philadelphia, PA: Saunders; 2013. p. 584.

    Google Scholar 

  66. Kaya D, Demirezen S, Hascelik G, Gulmez Kivanc D, Beksac MS. Comparison of PCR, culturing and Pap smear microscopy for accurate diagnosis of genital Actinomyces. J Med Microbiol. 2013;62(Pt 5):727–33.

    Article  CAS  PubMed  Google Scholar 

  67. Edwards T, Burke P, Smalley H, Hobbs G. Trichomonas vaginalis: clinical relevance, pathogenicity and diagnosis. Crit Rev Microbiol. 2016;42(3):406–17.

    CAS  PubMed  Google Scholar 

  68. Fichorova R, Fraga J, Rappelli P, Fiori PL. Trichomonas vaginalis infection in symbiosis with Trichomonasvirus and Mycoplasma. Res Microbiol. 2017;168(9–10):882–91.

    Article  PubMed  PubMed Central  Google Scholar 

  69. Fichorova RN. Impact of T. vaginalis infection on innate immune responses and reproductive outcome. J Reprod Immunol. 2009;83(1–2):185–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  70. Kirkcaldy RD, Augostini P, Asbel LE, Bernstein KT, Kerani RP, Mettenbrink CJ, et al. Trichomonas vaginalis antimicrobial drug resistance in 6 US cities, STD Surveillance Network, 2009–2010. Emerg Infect Dis. 2012;18(6):939–43.

    Article  PubMed  PubMed Central  Google Scholar 

  71. Jenniskens ML, Veerbeek JH, Deurloo KL, van Hannen EJ, Thijsen SF. Routine testing of Mycoplasma genitalium and Trichomonas vaginalis. Infect Dis (Lond). 2017;49(6):461–5.

    Article  Google Scholar 

  72. Kissinger P. Trichomonas vaginalis: a review of epidemiologic, clinical and treatment issues. BMC Infect Dis. 2015;15:307.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Madico G, Quinn TC, Rompalo A, McKee KT Jr, Gaydos CA. Diagnosis of Trichomonas vaginalis infection by PCR using vaginal swab samples. J Clin Microbiol. 1998;36(11):3205–10.

    CAS  PubMed  PubMed Central  Google Scholar 

  74. Fonseca THS, Oliveira FMS, Alacoque M, Rocha MI, Leite HV, Santos JFG, et al. Immunocytochemistry improving the diagnosis of trichomonas vaginalis infections. Biomed Res Int. 2017;2017:5642535.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  75. Van Der Pol B. Sexually transmitted infections in women. Scand J Clin Lab Invest Suppl. 2014;244:68–74. discussion 3

    Google Scholar 

  76. Crum CP, Nucci MR, Lee KR. Diagnostic gynecologic and obstetric pathology. 2nd ed. Philadelphia, PA: Elsevier Saunders; 2011. p. 1216.

    Google Scholar 

  77. CDC. Sexually transmitted disease surveillance 2014. Atlanta: US Department of Health and Human Services; 2015.

    Google Scholar 

  78. Smith L, Angarone MP. Sexually transmitted infections. Urol Clin North Am. 2015;42(4):507–18.

    Article  PubMed  Google Scholar 

  79. Abou M, Dallenbach P. Acute cervicitis and vulvovaginitis may be associated with Cytomegalovirus. BMJ Case Rep. 2013;2013:bcr2013008884.

    Article  PubMed  PubMed Central  Google Scholar 

  80. Sobel JD. Gynecologic infections in human immunodeficiency virus-infected women. Clin Infect Dis. 2000;31(5):1225–33.

    Article  CAS  PubMed  Google Scholar 

  81. Kemal KS, Foley B, Burger H, Anastos K, Minkoff H, Kitchen C, et al. HIV-1 in genital tract and plasma of women: compartmentalization of viral sequences, coreceptor usage, and glycosylation. Proc Natl Acad Sci U S A. 2003;100(22):12972–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  82. Herold BC, Keller MJ, Shi Q, Hoover DR, Carpenter CA, Huber A, et al. Plasma and mucosal HIV viral loads are associated with genital tract inflammation in HIV-infected women. J Acquir Immune Defic Syndr. 2013;63(4):485–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  83. Spear GT, St John E, Zariffard MR. Bacterial vaginosis and human immunodeficiency virus infection. AIDS Res Ther. 2007;4:25.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  84. Nardis C, Mosca L, Mastromarino P. Vaginal microbiota and viral sexually transmitted diseases. Ann Ig. 2013;25(5):443–56.

    CAS  PubMed  Google Scholar 

  85. Newman L, Rowley J, Vander Hoorn S, Wijesooriya NS, Unemo M, Low N, et al. Global estimates of the prevalence and incidence of four curable sexually transmitted infections in 2012 based on systematic review and global reporting. PLoS One. 2015;10(12):e0143304.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  86. Juzlova K, Rob F, Zakoucka H, Kubatova A, Secnikova Z, Krasova M, et al. The first case of lymphogranuloma venereum in a woman in East-Central Europe and its multiple co-infections. Folia Microbiol (Praha). 2018;63(1):93–5.

    Article  CAS  Google Scholar 

  87. Ceovic R, Gulin SJ. Lymphogranuloma venereum: diagnostic and treatment challenges. Infect Drug Resist. 2015;8:39–47.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  88. Gray DJ, Ross AG, Li YS, McManus DP. Diagnosis and management of schistosomiasis. BMJ. 2011;342:d2651.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Kjetland EF, Leutscher PD, Ndhlovu PD. A review of female genital schistosomiasis. Trends Parasitol. 2012;28(2):58–65.

    Article  PubMed  Google Scholar 

  90. Kjetland EF, Poggensee G, Helling-Giese G, Richter J, Sjaastad A, Chitsulo L, et al. Female genital schistosomiasis due to Schistosoma haematobium. Clinical and parasitological findings in women in rural Malawi. Acta Trop. 1996;62(4):239–55.

    Article  CAS  PubMed  Google Scholar 

  91. Swai B, Poggensee G, Mtweve S, Krantz I. Female genital schistosomiasis as an evidence of a neglected cause for reproductive ill-health: a retrospective histopathological study from Tanzania. BMC Infect Dis. 2006;6:134.

    Article  PubMed  PubMed Central  Google Scholar 

  92. Kjetland EF, Kurewa EN, Ndhlovu PD, Midzi N, Gwanzura L, Mason PR, et al. Female genital schistosomiasis--a differential diagnosis to sexually transmitted disease: genital itch and vaginal discharge as indicators of genital Schistosoma haematobium morbidity in a cross-sectional study in endemic rural Zimbabwe. Tropical Med Int Health. 2008;13(12):1509–17.

    Article  Google Scholar 

  93. Poggensee G, Feldmeier H. Female genital schistosomiasis: facts and hypotheses. Acta Trop. 2001;79(3):193–210.

    Article  CAS  PubMed  Google Scholar 

  94. Helling-Giese G, Sjaastad A, Poggensee G, Kjetland EF, Richter J, Chitsulo L, et al. Female genital schistosomiasis (FGS): relationship between gynecological and histopathological findings. Acta Trop. 1996;62(4):257–67.

    Article  CAS  PubMed  Google Scholar 

  95. Midzi N, Ndhlovu PD, Nyanga L, Kjetland EF, Reimert CM, Vennervald BJ, et al. Assessment of eosinophil cationic protein as a possible diagnostic marker for female genital schistosomiasis in women living in a Schistosoma haematobium endemic area. Parasite Immunol. 2003;25(11–12):581–8.

    Article  CAS  PubMed  Google Scholar 

  96. Norseth HM, Ndhlovu PD, Kleppa E, Randrianasolo BS, Jourdan PM, Roald B, et al. The colposcopic atlas of schistosomiasis in the lower female genital tract based on studies in Malawi, Zimbabwe, Madagascar and South Africa. PLoS Negl Trop Dis. 2014;8(11):e3229.

    Article  PubMed  PubMed Central  Google Scholar 

  97. Dennie J, Grover SR. Distressing perineal and vaginal pain in prepubescent girls: an aetiology. J Paediatr Child Health. 2013;49(2):138–40.

    Article  PubMed  Google Scholar 

  98. Kashyap B, Samantray JC, Kumar S, Jhamb R, Singh AK, Kaur IR. Recurrent paediatric pinworm infection of the vagina as a potential reservoir for Enterobius vermicularis. J Helminthol. 2014;88(3):381–3.

    Article  CAS  PubMed  Google Scholar 

  99. Tsai CY, Junod R, Jacot-Guillarmod M, Beniere C, Ziadi S, Bongiovanni M. Vaginal Enterobius vermicularis diagnosed on liquid-based cytology during papanicolaou test cervical cancer screening: a report of two cases and a review of the literature. Diagn Cytopathol. 2018;46(2):179–86.

    Article  PubMed  Google Scholar 

  100. Ngui R, Ravindran S, Ong DB, Chow TK, Low KP, Nureena ZS, et al. Enterobius vermicularis salpingitis seen in the setting of ectopic pregnancy in a Malaysian patient. J Clin Microbiol. 2014;52(9):3468–70.

    Article  PubMed  PubMed Central  Google Scholar 

  101. Garden AS. Vulvovaginitis and other common childhood gynaecological conditions. Arch Dis Child Educ Pract Ed. 2011;96(2):73–8.

    Article  PubMed  Google Scholar 

  102. Deshpande AD. Enterobius vermicularis live adult worms in the high vagina. Postgrad Med J. 1992;68(802):690–1.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  103. Mehrotra S, Young SL, Wojcik EM. Brown oval structures in vaginal Thin Prep smear: What could they be? Diagn Cytopathol. 2007;35(10):651–2.

    Article  PubMed  Google Scholar 

  104. Raju K, Verappa S, Venkataramappa SM. Enterobius vermicularis infestation masquerading as cervical carcinoma: a cytological diagnosis. J Nat Sci Biol Med. 2015;6(2):476–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  105. Richens J. Genital manifestations of tropical diseases. Sex Transm Infect. 2004;80(1):12–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  106. Nopdonrattakoon L. Amoebiasis of the female genital tract: a case report. J Obstet Gynaecol Res. 1996;22(3):235–8.

    Article  CAS  PubMed  Google Scholar 

  107. Munguia H, Franco E, Valenzuela P. Diagnosis of genital amebiasis in women by the standard Papanicolaou technique. Am J Obstet Gynecol. 1966;94(2):181–8.

    Article  CAS  PubMed  Google Scholar 

  108. Foda AA, El-Malky MM. Prevalence of genital tract infection with Entamoeba gingivalis among copper T 380A intrauterine device users in Egypt. Contraception. 2012;85(1):108–12.

    Article  PubMed  Google Scholar 

  109. Hyun KH, Shin HD, Kim DH. Malakoplakia in a healthy young female patient. Korean J Intern Med. 2013;28(4):475–80.

    Article  PubMed  PubMed Central  Google Scholar 

  110. Jimerson SD, Becker JD. Vaginal ulcers associated with tampon usage. Obstet Gynecol. 1980;56(1):97–9.

    CAS  PubMed  Google Scholar 

  111. LeRiche T, Black AY, Fleming NA. Toxic shock syndrome of a probable gynecologic source in an adolescent: a case report and review of the literature. J Pediatr Adolesc Gynecol. 2012;25(6):e133–7.

    Article  PubMed  Google Scholar 

  112. Tang YW, Himmelfarb E, Wills M, Stratton CW. Characterization of three Staphylococcus aureus isolates from a 17-year-old female who died of tampon-related toxic shock syndrome. J Clin Microbiol. 2010;48(5):1974–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  113. Ghoniem GM, Warda HA. The management of genitourinary fistula in the third millennium. Arab J Urol. 2014;12(2):97–105.

    Article  PubMed  PubMed Central  Google Scholar 

  114. Morris L, Do V, Chard J, Brand AH. Radiation-induced vaginal stenosis: current perspectives. Int J Womens Health. 2017;9:273–9.

    Article  PubMed  PubMed Central  Google Scholar 

  115. Haylen BT, Maher CF, Barber MD, Camargo S, Dandolu V, Digesu A, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic organ prolapse (POP). Int Urogynecol J. 2016;27(2):165–94.

    Article  PubMed  Google Scholar 

  116. Iglesia CB, Smithling KR. Pelvic organ prolapse. Am Fam Physician. 2017;96(3):179–85.

    PubMed  Google Scholar 

  117. Tjugum J, Jonassen F, Olsson JH. Vaginitis emphysematosa in a renal transplant patient. Acta Obstet Gynecol Scand. 1986;65(4):377–8.

    Article  CAS  PubMed  Google Scholar 

  118. Gardner HL, Fernet P. Etiology of vaginitis emphysematosa: report of ten cases and review of literature. Am J Obstet Gynecol. 1964;88:680–94.

    Article  CAS  PubMed  Google Scholar 

  119. Reichman O, Sobel J. Desquamative inflammatory vaginitis. Best Pract Res Clin Obstet Gynaecol. 2014;28(7):1042–50.

    Article  PubMed  Google Scholar 

  120. Mitchell L, King M, Brillhart H, Goldstein A. Cervical ectropion may be a cause of desquamative inflammatory vaginitis. Sex Med. 2017;5(3):e212–4.

    Article  PubMed  PubMed Central  Google Scholar 

  121. Shaw JL, Diamandis EP. A potential role for tissue kallikrein-related peptidases in human cervico-vaginal physiology. Biol Chem. 2008;389(6):681–8.

    Article  CAS  PubMed  Google Scholar 

  122. Chen S, Ge R, Zhu L, Yang S, Wu W, Yang Y, et al. Giant primary vaginal calculus secondary to vesicovaginal fistula with partial vaginal outlet obstruction in a 12-year-old girl. Urology. 2011;78(4):908–10.

    Article  PubMed  Google Scholar 

  123. Malhotra N, Kumar S, Roy KK, Agarwal R, Verma V. Vaginal calculus secondary to vaginal outlet obstruction. J Clin Ultrasound. 2004;32(4):204–6.

    Article  PubMed  Google Scholar 

  124. Rahn DD, Carberry C, Sanses TV, Mamik MM, Ward RM, Meriwether KV, et al. Vaginal estrogen for genitourinary syndrome of menopause: a systematic review. Obstet Gynecol. 2014;124(6):1147–56.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  125. Pradhan S, Tobon H. Vaginal cysts: a clinicopathological study of 41 cases. Int J Gynecol Pathol. 1986;5(1):35–46.

    Article  CAS  PubMed  Google Scholar 

  126. Steinberg BJ, Mapp T, Mama S, Echols KT. Surgical treatment of persistent vaginal granulation tissue using CO(2) laser vaporization under colposcopic and laparoscopic guidance. JSLS. 2012;16(3):488–91.

    Article  PubMed  PubMed Central  Google Scholar 

  127. Proppe KH, Scully RE, Rosai J. Postoperative spindle cell nodules of genitourinary tract resembling sarcomas. A report of eight cases. Am J Surg Pathol. 1984;8(2):101–8.

    Article  CAS  PubMed  Google Scholar 

  128. Zhao J, Ping H, Xing N. Postoperative spindle cell nodule of the bladder: a case report and review of the literature. Oncol Lett. 2014;7(5):1507–10.

    Article  PubMed  PubMed Central  Google Scholar 

  129. Alderman M, Kunju LP. Inflammatory myofibroblastic tumor of the bladder. Arch Pathol Lab Med. 2014;138(10):1272–7.

    Article  PubMed  Google Scholar 

  130. Harik LR, Merino C, Coindre JM, Amin MB, Pedeutour F, Weiss SW. Pseudosarcomatous myofibroblastic proliferations of the bladder: a clinicopathologic study of 42 cases. Am J Surg Pathol. 2006;30(7):787–94.

    Article  PubMed  Google Scholar 

  131. Song YS, Kang JS, Park MH. Fallopian tube prolapse misdiagnosed as vault granulation tissue: a report of three cases. Pathol Res Pract. 2005;201(12):819–22.

    Article  PubMed  Google Scholar 

  132. Silverberg SG, Frable WJ. Prolapse of fallopian tube into vaginal vault after hysterectomy. Histopathology, cytopathology, and differential diagnosis. Arch Pathol. 1974;97(2):100–3.

    CAS  PubMed  Google Scholar 

  133. Wheelock JB, Schneider V, Goplerud DR. Prolapsed fallopian tube masquerading as adenocarcinoma of the vagina in a postmenopausal woman. Gynecol Oncol. 1985;21(3):369–75.

    Article  CAS  PubMed  Google Scholar 

  134. Fadare O. Vaginal stromal sclerosis: a distinctive stromal change associated with vaginal atrophy. Int J Gynecol Pathol. 2011;30(3):295–300.

    Article  PubMed  Google Scholar 

  135. Pehlivanov B, Belovegdov V, Ivanov G, Ivancheva H. Primary localised amyloidosis of the vagina. Aust N Z J Obstet Gynaecol. 2008;48(1):120–2.

    Article  CAS  PubMed  Google Scholar 

  136. Altinkaya SO, Uzunlar O, Talas BB, Ozat M, Bilge U. Ligneous cervicovaginitis. Taiwan J Obstet Gynecol. 2008;47(3):363–6.

    Article  PubMed  Google Scholar 

  137. Chi AC, Prichard E, Richardson MS, Rasenberger KP, Weathers DR, Neville BW. Pseudomembranous disease (ligneous inflammation) of the female genital tract, peritoneum, gingiva, and paranasal sinuses associated with plasminogen deficiency. Ann Diagn Pathol. 2009;13(2):132–9.

    Article  PubMed  Google Scholar 

  138. Nielsen GP, Young RH. Mesenchymal tumors and tumor-like lesions of the female genital tract: a selective review with emphasis on recently described entities. Int J Gynecol Pathol. 2001;20(2):105–27.

    Article  CAS  PubMed  Google Scholar 

  139. Norris HJ, Taylor HB. Polyps of the vagina. A benign lesion resembling sarcoma botryoides. Cancer. 1966;19(2):227–32.

    Article  CAS  PubMed  Google Scholar 

  140. Nucci MR, Young RH, Fletcher CD. Cellular pseudosarcomatous fibroepithelial stromal polyps of the lower female genital tract: an underrecognized lesion often misdiagnosed as sarcoma. Am J Surg Pathol. 2000;24(2):231–40.

    Article  CAS  PubMed  Google Scholar 

  141. McCluggage WG, Young RH. Tubulo-squamous polyp: a report of ten cases of a distinctive hitherto uncharacterized vaginal polyp. Am J Surg Pathol. 2007;31(7):1013–9.

    Article  PubMed  Google Scholar 

  142. Dundr P, Povysil C, Mara M, Kuzel D. Tubulo-squamous polyp of the vagina. Cesk Patol. 2008;44(2):45–7.

    CAS  PubMed  Google Scholar 

  143. Chaturvedi A, Padel A. Tubulo-squamous polyp of the vagina with sebaceous glands: novel features in an uncommon recently described entity. Int J Gynecol Pathol. 2010;29(5):494–6.

    Article  PubMed  Google Scholar 

  144. Tong B, Clarke BA, Ghazarian D. Tubulo-squamous polyp with mucinous and goblet cell differentiation: a unique morphologic variant. Int J Gynecol Pathol. 2011;30(5):518–9.

    Article  PubMed  Google Scholar 

  145. Stewart CJ. Tubulo-squamous vaginal polyp with basaloid epithelial differentiation. Int J Gynecol Pathol. 2009;28(6):563–6.

    Article  PubMed  Google Scholar 

  146. Kazakov DV, Stewart CJ, Kacerovska D, Leake R, Kreuzberg B, Chudacek Z, et al. Prostatic-type tissue in the lower female genital tract: a morphologic spectrum, including vaginal tubulosquamous polyp, adenomyomatous hyperplasia of paraurethral Skene glands (female prostate), and ectopic lesion in the vulva. Am J Surg Pathol. 2010;34(7):950–5.

    Article  PubMed  Google Scholar 

  147. Berdugo J, Gauthier P, Provencher D, Matte C, Piche J, Rahimi K. Spindle cell epithelioma of the vagina: report of two cases, literature review, and new immunohistochemical markers. Int J Surg Pathol. 2015;23(8):677–81.

    Article  CAS  PubMed  Google Scholar 

  148. Park S, Cho MS. Vaginal Brenner tumor with literature review: does this tumour originate from Walthard nests? Malays J Pathol. 2017;39(1):89–93.

    CAS  PubMed  Google Scholar 

  149. Young RH, Clement PB. Endocervicosis involving the uterine cervix: a report of four cases of a benign process that may be confused with deeply invasive endocervical adenocarcinoma. Int J Gynecol Pathol. 2000;19(4):322–8.

    Article  CAS  PubMed  Google Scholar 

  150. Clement PB, Young RH. Endocervicosis of the urinary bladder. A report of six cases of a benign mullerian lesion that may mimic adenocarcinoma. Am J Surg Pathol. 1992;16(6):533–42.

    Article  CAS  PubMed  Google Scholar 

  151. Martinka M, Allaire C, Clement PB. Endocervicosis presenting as a painful vaginal mass: a case report. Int J Gynecol Pathol. 1999;18(3):274–6.

    Article  CAS  PubMed  Google Scholar 

  152. McCluggage WG, Price JH, Dobbs SP. Primary adenocarcinoma of the vagina arising in endocervicosis. Int J Gynecol Pathol. 2001;20(4):399–402.

    Article  CAS  PubMed  Google Scholar 

  153. Stern RC, Dash R, Bentley RC, Snyder MJ, Haney AF, Robboy SJ. Malignancy in endometriosis: frequency and comparison of ovarian and extraovarian types. Int J Gynecol Pathol. 2001;20(2):133–9.

    Article  CAS  PubMed  Google Scholar 

  154. Gardner HL. Cervical and vaginal endometriosis. Clin Obstet Gynecol. 1966;9(2):358–72.

    Article  CAS  PubMed  Google Scholar 

  155. Liu L, Davidson S, Singh M. Mullerian adenosarcoma of vagina arising in persistent endometriosis: report of a case and review of the literature. Gynecol Oncol. 2003;90(2):486–90.

    Article  PubMed  Google Scholar 

  156. Nomoto K, Hori T, Kiya C, Fukuoka J, Nakashima A, Hidaka T, et al. Endometrioid adenocarcinoma of the vagina with a microglandular pattern arising from endometriosis after hysterectomy. Pathol Int. 2010;60(9):636–41.

    Article  PubMed  Google Scholar 

  157. Guercio F. Adenosis of the vagina and its consequences. Arch Ostet Ginecol. 1959;64:588–600.

    CAS  PubMed  Google Scholar 

  158. Scully RE, Robboy SJ, Herbst AL. Vaginal and cervical abnormalities, including clear-cell adenocarcinoma, related to prenatal exposure to stilbestrol. Ann Clin Lab Sci. 1974;4(4):222–33.

    CAS  PubMed  Google Scholar 

  159. Robboy SJ, Taguchi O, Cunha GR. Normal development of the human female reproductive tract and alterations resulting from experimental exposure to diethylstilbestrol. Hum Pathol. 1982;13(3):190–8.

    Article  CAS  PubMed  Google Scholar 

  160. Forsberg JG. Animal model of human disease: adenosis and clear-cell carcinomas of vagina and cervix. Am J Pathol. 1976;84(3):669–72.

    CAS  PubMed  PubMed Central  Google Scholar 

  161. Ganesan R, Ferryman SR, Waddell CA. Vaginal adenosis in a patient on Tamoxifen therapy: a case report. Cytopathology. 1999;10(2):127–30. discussion 31

    Article  CAS  PubMed  Google Scholar 

  162. Goodman A, Zukerberg LR, Nikrui N, Scully RE. Vaginal adenosis and clear cell carcinoma after 5-fluorouracil treatment for condylomas. Cancer. 1991;68(7):1628–32.

    Article  CAS  PubMed  Google Scholar 

  163. Lu W, Zhang X, Lu B. Benign intestinal glandular lesions in the vagina: a possible correlation with implantation. Diagn Pathol. 2016;11(1):52.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  164. Merchant WJ, Gale J. Intestinal metaplasia in stilboestrol-induced vaginal adenosis. Histopathology. 1993;23(4):373–6.

    Article  CAS  PubMed  Google Scholar 

  165. Antonioli DA, Burke L. Vaginal adenosis. Analysis of 325 biopsy specimens from 100 patients. Am J Clin Pathol. 1975;64(5):625–38.

    Article  CAS  PubMed  Google Scholar 

  166. Hart WR, Townsend DE, Aldrich JO, Henderson BE, Roy M, Benton B. Histopathologic spectrum of vaginal adenosis and related changes in stilbestrol-exposed females. Cancer. 1976;37(2):763–75.

    Article  CAS  PubMed  Google Scholar 

  167. Robboy SJ, Noller KL, O'Brien P, Kaufman RH, Townsend D, Barnes AB, et al. Increased incidence of cervical and vaginal dysplasia in 3,980 diethylstilbestrol-exposed young women. Experience of the National Collaborative Diethylstilbestrol Adenosis Project. JAMA. 1984;252(21):2979–83.

    Article  CAS  PubMed  Google Scholar 

  168. Antonioli DA, Rosen S, Burke L, Donahue V. Glandular dysplasia in diethylstilbestrol-associated vaginal adenosis. A case report and review of the literature. Am J Clin Pathol. 1979;71(6):715–21.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

This chapter was supported by Ministry of Health, Czech Republic—conceptual development of research organization 64165, General University Hospital in Prague, Czech Republic.

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  1. First Faculty of Medicine, Institute of Pathology, Charles University and General University Hospital in Prague, Prague, Czech Republic

    Pavel Dundr, Kristýna Němejcová & Michaela Bártů

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  1. Pavel Dundr
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  2. Kristýna Němejcová
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  3. Michaela Bártů
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Correspondence to Pavel Dundr .

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Editors and Affiliations

  1. Department of Pathology, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Wenxin Zheng

  2. Department of Pathology, University of California San Diego, San Diego, CA, USA

    Oluwole Fadare

  3. Department of Pathology, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Charles Matthew Quick

  4. Department of Pathology, Peking University People’s Hospital, Beijing, China

    Danhua Shen

  5. Department of Obstetrics and Gynecology, Tianjin Gynecologic and Obstetrics Central Hospital, Tianjin, China

    Donghui Guo

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Dundr, P., Němejcová, K., Bártů, M. (2019). Benign Lesions of the Vagina. In: Zheng, W., Fadare, O., Quick, C., Shen, D., Guo, D. (eds) Gynecologic and Obstetric Pathology, Volume 1. Springer, Singapore. https://doi.org/10.1007/978-981-13-3016-2_9

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