Glossary - V

Vaginal malignancies

Vaginal malignancies. Vaginal intraepithelial neoplasia (carcinoma in situ) Is a premalignant phase with full thickness neoplastic changes in the superficial epithelium. There is no invasion through the basement membrane. Invasive malignancies are Vaginal malignancies with squamous cell in 90% of the patients and the remaining 10% are adenocarcinomas, sarcomas and melanomas. To be classified as a vaginal malignancy, only the vagina can be involved. The clear cell carcinoma is a subtype of adenocarcinoma. If the cervix or the vulva is involved, then the tumor is classified as a primary cancer, arising from the cervix or vulva. There is no genetic pattern. It affects the reproductive system. It is also the rarest of all gynecological malignancies in the United States. Carcinoma in situ affects adults between the ages of 40 and 60. Invasive squamous cell malignancy affects those between the ages of 60 and 70. Adenocarcinoma affects any age, with 50 as the mean. Mixed muellerian sarcomas and leiomyosarcomas peaks at the mean age of 60. Sarcoma botryoides and embryonal sarcomas occur in the pediatric population. Signs and symptoms include abnormal bleeding (from the a fungating tumor present in the vagina), dyspareunia, post coital bleeding from direct trauma to the tumor and pain. In the pediatric population, sarcomas can present either as a mass protruding from the vagina or as abnormal genital bleeding. Women with a history of cervical malignancy have a higher probability of developing squamous cell malignancy in the vagina after hysterectomy. The human papilloma virus has been associated with vulvovaginal, cervical, adenocarcinoma and squamous cell carcinoma. Smokers have a higher incidence of the disease. Clear cell adenocarcinoma of the vagina in young women have been associated with diethylstilbestrol(DES) exposure. The incidence is very rare in DES exposed females. Metastatic lesions can involve the vagina from the other gynecologic organs.

Varicose veins

Varicose veins are elongated, dilated, tortuous superficial veins with congenitally absent valves, or valves that have become incompetent. It affects the legs where reverse flow occurs when dependent. It affects the Cardiovascular and Skin/Exocrine systems. The disease is familial, dominant and X-linked. It predominates middle age,with females having a higher incidence than males. About 20% of adults in the United States have the disease. Signs and symptoms include leg muscular cramp, dilation and tortuosity of superficial veins chiefly in the lower extremities, edema of affected limb, leg ache, fatigue and/or pain if varicose ulcer develops. Causes include faulty valves in one or more perforator veins in the lower leg causing secondary incompetence of the saphenofemal junction, deep thrombophlebitis, increased venous pressure from any cause and in many individuals, no cause or precipitating factor is found. Those at risk include pregnant women and occupations requiring prolonged standing and restrictive clothing (e.g. tight girdles).

Viral Hepatitis

Viral Hepatitis is a group of systematic infections involving the liver with common clinical manifestations, but caused by different viruses with distinctive disease patterns. The signs and symptoms include: fever, malaise, nausea, anorexia, jaundice, dark urine, abdominal pain, headache, and vomiting. The causes of the disease range from multiple viruses (may be simultaneous infection with more than one virus), contaminated food products, and sexually through blood as well as blood transfusions. The virus occurs in all ages and affects the gastrointestinal system. High risk groups include health care workers, hemodialysis patients, IV drug users, sexually active homosexual males, and blood recipients.

 

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