Vaginal adenosis is a benign abnormality in the vagina, commonly thought to be caused by intrauterine and neonatal exposure of diethylstilbestrol and other and nonsteroidal estrogens, however it has also been observed in otherwise healthy women and has been considered at times idiopathy or congenital. Postpubertal lesions have also been observed to grow . It has a rather common incidence, of about 10% of adult women.
Causes
Vaginal adenosis is characterised by the presence of
metaplastic cervical or
endometrium epithelium within the vaginal wall, considered as derived from Müllerian epithelium islets in later life. In women who were exposed to certain chemicals, vaginal adenosis may arise in up to 90%. Since these
contraceptives were discontinued, incidence has dropped dramatically.
is however still present in subsequent generations due to recent exposure.
It is thought play a stimulatory growth in adenosis formation.
Diagnosis
Colposcopy, it presents itself similarly to columnar epithelium on the
cervix, assisted with lugol's solution application for diagnosis.
It can be discovered as nodules or
on the vaginal tube, with
biopsy needed for further diagnosis. As seen
cytology, epithelial and
stromal cells in vaginal adenosis show characteristic fusion through the
basal lamina or with stromal
.
Adenosal cells can be distinguished as
mucinous, tuboendometrial, and
embryonic cell. Its mucinous cells resemble the normal cervical lining, while its tuboendometrial cells resemble the lining of normal
or endometrium.
It is sometimes considered a precancerous lesion, given clear-cell adenocarcinoma patients present these lesions in close proximity to atypical tuboendometrial glands,
Further reading
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PMID 22682699.
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Laronda, M. M.; Unno, K.; Ishi, K.; Serna, V. A.; Butler, L. M; Mills, A. A.; Orvis, G. D.; Behringer, R. R.; Deng, C.; Sinha, S.; Kurita, T. (2013). "Diethylstilbestrol induces vaginal adenosis by disrupting SMAD/RUNX1-mediated cell fate decision in the Müllerian duct epithelium". Developmental Biology 381(1): 5-16. doi: 10.1016/j.ydbio.2013.06.024. PMID 23830984.
