The Pathologist’s Perspective
Good pathology is crucial to the management of vulvovaginal disease, but how is good pathology obtained? There are two clinical situations in which a tissue sample is sent for pathology: rashes and discrete lesions. Rashes are sent for accurate pathological diagnosis, but lesions require in addition to confirmation of clinical diagnosis, the pathological assessment of prognostic factors and margins. This eChapter describes both approaches in detail, including biopsy techniques, and tips on how to read and understand a pathologist’s report.
The eChapter begins by considering three critical components that ultimately influence the pathologist’s contribution to the diagnosis of vulvovaginal disease: the clinical history and diagnosis, the site of the biopsy, and the type of biopsy. Biopsy techniques are described for maculpapular rashes, erosive or ulcerative rashes and discrete lesions, and illustrations are provided. The next section outlines the contents of a typical pathologist’s report, including an interesting explication of how pathologists work by pattern recognition. The limitations of pathological diagnosis are then discussed, using the context of specific diseases such as psoriasis, fungal infections and non-infectious inflammatory disoreders to illustrate the key concepts of the section. The author then begins an extended discussion on the importance of communication between the clinician and the pathologist, and provides guidance on the avoidance of confusion with pathological terms, with specific examples such as squamous cell hyperplasia given to illustrate the problem. The chapter concludes with an explanation of the dermatological classification system.
This eChapter forms part of the Ausmed publication The Vulva and Vaginal Manual, edited by Graeme Dennerstein, James Scurry, John Brenan, David Allen and Maria-Grazia Marin. A richly illustrated and comprehensive guide to the identification and treatment of over 275 vulvovaginal diseases The Vulva and Vaginal Manual is an invaluable resource especially suitable for:
- General Practitioners
- General nurses
- Practice nurses
- Nurse Practitioners
There are also 14 additional eChapters from The Vulva and Vaginal Manual available for members to download from the Ausmed website. Subscription also entitles members to access the full range of resources that compliment and build upon the material described within The Vulva and Vaginal Manual, including a richly populated catalogue of Audio Lectures, Fast Facts and Video Learning Activities on the topics of gynecology, obstetrics, oncology, women’s health and a wide range of other healthcare topics. Both members and non-subscribers alike may also purchase a hard copy of this book of from the Ausmed Education Online Bookstore, along with hard copies of the complimentary publication Gynecological Cancer Care: A Guide to Practice.
- The importance of clinical history and diagnosis
- Biopsy sites and types of biopsy
- Biopsy techniques for Maculopapular, erosive and ulcerative rashes and discrete lesions
- How to read a pathologist’s report
- Communication between the pathologist and the clinician: avoiding confusion
- How pathological findings are classified.