Ligneous Vaginitis
Marisa R. Nucci, MD
Key Facts
Etiology/Pathogenesis
Inherited type I plasminogen deficiency
Clinical Issues
Degree and extent of associated clinical symptoms and signs not predictable
Microscopic Pathology
Subepithelial accumulation of amorphic, eosinophilic material (fibrin)
Ancillary Tests
Mutation in plasminogen (PLG) gene
Top Differential Diagnoses
Amyloidosis
Commonly involves vessel walls
Congo red positive with apple-green birefringence
 Ligneous vaginitis is characterized by subepithelial accumulation of amorphous eosinophilic material. Note the presence of associated pseudoepitheliomatous hyperplasia. |
 The amorphous eosinophilic material that is deposited in ligneous vaginitis is an abnormal accumulation of fibrin, secondary to a mutation in the plasminogen gene. |
TERMINOLOGY
Synonyms
Pseudomembranous vaginitis
Definitions
Disorder secondary to plasminogen deficiency resulting in wood-like lesions of mucosae with extensive subepithelial fibrin deposition associated with inflammation
ETIOLOGY/PATHOGENESIS
Hereditary
Inherited type I plasminogen deficiency (inherited hypoplasminogenemia)
Decreased plasminogen levels and functional activity due to impaired secretion and increased degradation
Impaired plasmin-mediated extracellular fibrinolysis leads to accumulation of cross-linked fibrin deposited in previously injured or inflamed tissue
CLINICAL ISSUES
