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By Jan Langman M.D., Ph.D., Doris Burda Wilson Ph.D. (auth.), Ancel Blaustein M.D. (eds.)
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Epithelial Tumors Because the "milk line" extends into the vulva, the occurrence of breast tissue in this location is not strictly ectopic, but rather accessory. The amount and character of breast tissue reported within the labia majoria varies from small, isolated nodules of mammary duct epithelium to large, bilateral structures that have been observed to lactate during the puerperium. 65 Histologically, accessory breast tissue is identical with that of mammary structures elsewhere, but a higher incidence of malignancy develops in accessory sites, and adenocarcinoma of the accessory breast tissue of the vulva78 has been reported.
Fig. 22. Mucous cyst of the vestibule. Simple columnar mucussecreting cells rest on the basement membrane. Note absence of underlying smooth muscle layer. 28 Eduard G. Friedrich, Jr. and Edward J. Wilkinson Cysts of the Canal of N uck (Peritoneal Lined Cysts) Cysts of the canal of Nuck are generally found in the superior aspect of the labia majora or inguinal canal and are believed to arise from inclusions of the peritoneum at the inferior insertion of the round ligament into the labia majora. As such, they are analogous to the hydrocele of the spermatic cord.
Biopsy is often indicated to rule out carcinoma; smears of the base of the biopsy should be made to search for the Donovan bodies of granuloma inguinale. Histologically, giant cells may be seen along with lymphocytes and plasma cells. Older lesions exhibit extensive fibrosis of the dermis and, occasionally, the biopsy will contain sinus tracts. Chancroid Chancroid is caused by the organism Haemophilus ducreyi, a gram-negative, nonmotile bacillus, and in culture grows in pairs and chains. This disease is now extremely rare, and very few cases have been documented with positive cultures.