Medicine an Surgery notes

Apr 24th, 2015
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PREMALIGNANT &MALIGNANT CONDITIONS OFTHE VAGINAVaginal Intraepithelial Neoplasia(VAIN)EPIDEMIOLOGY The true incidence of VAIN is unknown,but is estimated at 0.2 to 0.3 cases per100,000 women in the US. The average patient is between 43 and 60years of age, slightly younger than the agefor vaginal carcinoma .Vaginal Intraepithelial Neoplasia(VAIN)The diagnosis of VAIN has increasedsteadily over the past several decades asa result of heightened awareness expanded cytologic screening liberal use of colposcopy.VAIN is far less common than cervical orvulvar intraepithelial neoplasia (CIN orVIN)Vaginal Intraepithelial Neoplasia(VAIN)Risk factors Infection with human papillomavirus (HPV); theoncogenic types 16 and 18 low level of education,low family income history of vaginal condyloma Genetic and acquired immuno-suppression, includinghuman immunodeficiency virus (HIV) infection Prior or concurrent neoplasia elsewhere in the lowergenital tract- intraepithelial neoplasia or carcinoma of thecervix or vulva Exposure to DES in utero often cauisng squamousmetaplasia of the vagina, instead of normal columnarepitheliumVAINCLASSIFICATION Vaginal intraepithelial neoplasia is defined bythe presence of squamous cell atypia withoutinvasion. Classfication is according to the depth ofepithelial involvement: VAIN I; involve the lower one-third of the epithelium, VAIN II involve the lower two-thirds of

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