Abstract
AIMS: To study the nature of fibroepithelial polyps of the vagina. METHODS: Sixty five fibroepithelial polyps of the vagina and 64 granulation tissue polyps diagnosed over 15 years were reviewed histologically. RESULTS: Cytologically benign multinucleated stromal cells were present in large numbers in 19 of the fibroepithelial polyps of the vagina (FEPV). Only one polyp contained atypical stromal cells, a high mitotic count, and abnormal mitoses and was indistinguishable from a malignant tumour. Immunostaining showed the presence of vimentin and desmin positive mono- and multinucleated stromal cells in FEPV and occasional oestrogen receptor positive nuclei. Desmin positive cells could not be shown in granulation tissue polyps. CONCLUSIONS: FEPV are common lesions with benign mono- and multinucleated fibroblastic stromal cells in which myoid differentiation is often present. FEPV may develop as a result of a granulation tissue reaction after some local injury of the vaginal mucosa. Hormonal factors may modulate the growth of FEPVs. Delayed differentiation of myofibroblastic cells may explain why granulation tissue sometimes does not contract properly but turns into polyps.
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- Abdul-Karim F. W., Cohen R. E. Atypical stromal cells of lower female genital tract. Histopathology. 1990 Sep;17(3):249–253. doi: 10.1111/j.1365-2559.1990.tb00715.x. [DOI] [PubMed] [Google Scholar]
- Atkins F. M., Friedman M. M., Subba Rao P. V., Metcalfe D. D. Interactions between mast cells, fibroblasts and connective tissue components. Int Arch Allergy Appl Immunol. 1985;77(1-2):96–102. doi: 10.1159/000233760. [DOI] [PubMed] [Google Scholar]
- Chirayil S. J., Tobon H. Polyps of the vagina: a clinicopathologic study of 18 cases. Cancer. 1981 Jun 15;47(12):2904–2907. doi: 10.1002/1097-0142(19810615)47:12<2904::aid-cncr2820471227>3.0.co;2-5. [DOI] [PubMed] [Google Scholar]
- Citrin D. L., Hogan T. F., Davis T. E. A study of cyclophosphamide, adriamycin, cis-platinum, and methotrexate in advanced transitional cell carcinoma of the urinary tract. Cancer. 1983 Jan 1;51(1):1–4. doi: 10.1002/1097-0142(19830101)51:1<1::aid-cncr2820510102>3.0.co;2-y. [DOI] [PubMed] [Google Scholar]
- Clement P. B. Multinucleated stromal giant cells of the uterine cervix. Arch Pathol Lab Med. 1985 Feb;109(2):200–202. [PubMed] [Google Scholar]
- Dabbous M. K., Woolley D. E., Haney L., Carter L. M., Nicolson G. L. Host-mediated effectors of tumor invasion: role of mast cells in matrix degradation. Clin Exp Metastasis. 1986 Apr-Jun;4(2):141–152. doi: 10.1007/BF00119080. [DOI] [PubMed] [Google Scholar]
- Davies S. W., Makanje H. H., Woodcock A. S. Pseudo-sarcomatous polyps of the vagina in pregnancy. Case report. Br J Obstet Gynaecol. 1981 May;88(5):566–568. doi: 10.1111/j.1471-0528.1981.tb01035.x. [DOI] [PubMed] [Google Scholar]
- Elliott G. B., Elliott J. D. Superficial stromal reactions of lower genital tract. Arch Pathol. 1973 Feb;95(2):100–101. [PubMed] [Google Scholar]
- Hartmann C. A., Sperling M., Stein H. So-called fibroepithelial polyps of the vagina exhibiting an unusual but uniform antigen profile characterized by expression of desmin and steroid hormone receptors but no muscle-specific actin or macrophage markers. Am J Clin Pathol. 1990 May;93(5):604–608. doi: 10.1093/ajcp/93.5.604. [DOI] [PubMed] [Google Scholar]
- Hsu S. M., Raine L., Fanger H. Use of avidin-biotin-peroxidase complex (ABC) in immunoperoxidase techniques: a comparison between ABC and unlabeled antibody (PAP) procedures. J Histochem Cytochem. 1981 Apr;29(4):577–580. doi: 10.1177/29.4.6166661. [DOI] [PubMed] [Google Scholar]
- Hughes D. F., Biggart J. D., Hayes D. Pseudosarcomatous lesions of the urinary bladder. Histopathology. 1991 Jan;18(1):67–71. doi: 10.1111/j.1365-2559.1991.tb00816.x. [DOI] [PubMed] [Google Scholar]
- Kessler D. A., Langer R. S., Pless N. A., Folkman J. Mast cells and tumor angiogenesis. Int J Cancer. 1976 Nov 15;18(5):703–709. doi: 10.1002/ijc.2910180520. [DOI] [PubMed] [Google Scholar]
- Kindblom L. G., Angervall L. Nasal polyps with atypical stroma cells: a pseudosarcomatous lesion. A light and electron-microscopic and immunohistochemical investigation with implications on the type and nature of the mesenchymal cells. Acta Pathol Microbiol Immunol Scand A. 1984 Jan;92(1):65–72. [PubMed] [Google Scholar]
- Mitchell M., Talerman A., Sholl J. S., Okagaki T., Cibils L. A. Pseudosarcoma botyroides in pregnancy: report of a case with ultrastructural observations. Obstet Gynecol. 1987 Sep;70(3 Pt 2):522–526. [PubMed] [Google Scholar]
- Mucitelli D. R., Charles E. Z., Kraus F. T. Vulvovaginal polyps. Histologic appearance, ultrastructure, immunocytochemical characteristics, and clinicopathologic correlations. Int J Gynecol Pathol. 1990;9(1):20–40. [PubMed] [Google Scholar]
- Mäenpä J., Söderström K. O., Salmi T., Ekblad U. Large atypical polyps of the vagina during pregnancy with concomitant human papilloma virus infection. Eur J Obstet Gynecol Reprod Biol. 1988 Jan;27(1):65–69. doi: 10.1016/s0028-2243(88)80012-1. [DOI] [PubMed] [Google Scholar]
- Norris H. J., Taylor H. B. Polyps of the vagina. A benign lesion resembling sarcoma botryoides. Cancer. 1966 Feb;19(2):227–232. doi: 10.1002/1097-0142(196602)19:2<227::aid-cncr2820190214>3.0.co;2-w. [DOI] [PubMed] [Google Scholar]
- O'Quinn A. G., Edwards C. L., Gallager H. S. Pseudosarcoma botryoides of the vagina in pregnancy. Gynecol Oncol. 1982 Apr;13(2):237–241. doi: 10.1016/0090-8258(82)90032-4. [DOI] [PubMed] [Google Scholar]
- Ostör A. G., Fortune D. W., Riley C. B. Fibroepithelial polyps with atypical stromal cells (pseudosarcoma botryoides) of vulva and vagina. A report of 13 cases. Int J Gynecol Pathol. 1988;7(4):351–360. doi: 10.1097/00004347-198812000-00006. [DOI] [PubMed] [Google Scholar]
- Roche W. R. Mast cells and tumors. The specific enhancement of tumor proliferation in vitro. Am J Pathol. 1985 Apr;119(1):57–64. [PMC free article] [PubMed] [Google Scholar]
- Rollason T. P., Byrne P., Williams A. Immunohistochemical and electron microscopic findings in benign fibroepithelial vaginal polyps. J Clin Pathol. 1990 Mar;43(3):224–229. doi: 10.1136/jcp.43.3.224. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ryan G. B., Cliff W. J., Gabbiani G., Irlé C., Montandon D., Statkov P. R., Majno G. Myofibroblasts in human granulation tissue. Hum Pathol. 1974 Jan;5(1):55–67. doi: 10.1016/s0046-8177(74)80100-0. [DOI] [PubMed] [Google Scholar]
- Taylor C. R., Burns J. The demonstration of plasma cells and other immunoglobulin-containing cells in formalin-fixed, paraffin-embedded tissues using peroxidase-labelled antibody. J Clin Pathol. 1974 Jan;27(1):14–20. doi: 10.1136/jcp.27.1.14. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Young R. H., Scully R. E. Pseudosarcomatous lesions of the urinary bladder, prostate gland, and urethra. A report of three cases and review of the literature. Arch Pathol Lab Med. 1987 Apr;111(4):354–358. [PubMed] [Google Scholar]