Vulvar cytology

Specimen:

Moist lesions or those from the introitus may be scraped using a wooden spatula. 

Other lesions in the vulva will be dry and improved cellular preservation will result from rubbing the area with a cottonwool swab dipped in saline and then rolling the swab onto a pre-labelled glass slide. 

Alternatively careful scraping with a scalpel blade may yield diagnostic material. 

Touch preparations and brush samples may also be obtained from ulcerated lesions. 

To avoid air-drying problems, rapid fixation is important.

Method:

Papanicolaou staining and microscopy.

Application:

Benign and malignant vulval lesions. May be used in combination with colposcopy for follow-up after treatment of VIN.

Interpretation:

Cytologic examination can demonstrate the presence of dysplasia, neoplasia, fungal and viral infections eg, Herpes simplex virus. 

Reference:

Gray W and Kocjan G eds. Diagnostic Cytopathology.  3rd ed. 2010. Churchill Livingstone.