Mucinous Glands

There are vulvar and urethral, but normally no vaginal mucinous glands. The mucin-ous glands are exocrine and consist of mucinous acini that drain into a duct system lined by pseudostratified columnar epithelium. The largest are the major vestibular (Bartholin's) glands (Fig. 15). These have well-developed lobules and ducts that normally open at the posterolateral five and seven o'clock positions of the introitus, just external to the hymenal ring.

The minor vestibular glands are a variable number of tiny glands found in a ring around the introitus. They are usually seen as incidental histological findings in vestibular biopsies or vestibulectomy specimens. They are located in the lamina propria and are composed of one or a few mucinous acini opening into a duct lined by stratified mucinous epithelium. The ostia open just external to the hymenal ring (Figs. 16 and 17). There is commonly an associated moderate lymphocytic infiltrate, even in asymptomatic women.

Numerous microscopic mucinous glands are observed in the wall of the urethra, but the nature of these glands is still controversial. Wenert et al. found peri-urethral glands formed by prostate-specific antigen (PSA)-staining cells in 66.7% of 33 cases in female urethras removed at autopsy and embedded entirely for histologi-cal examination (14). The glands were located at the distal two-thirds of the urethra (95% of females). In 73% of subjects, the glands were exclusively dorsal and lateral,

Vulvar Disease
Figure 15 A lobule of mucinous acini of the greater vestibular (Bartholin's) gland.
Vestibular Gland
Figure 16 A vestibular gland appears as a few mucinous acini around a duct. The periglandular lymphocytic infiltrate is common in asymptomatic women. Periurethral glands show a similar appearance.

and in 14%, circumferential. The glands were in the lamina propria or deeper tissues, and could be found in the smooth muscle of the septum urethrovaginale. Irrespective of age, they resembled the male prostate before puberty, with immature glands. Wenert et al. do not state whether they also found a population of non-PSA-secreting mucinous glands. Wenert et al.'s (14) findings support homology between male and female embryological development and explain the rare, but well-documented finding of a

Paraurethral Ducts Photos
Figure 17 The duct of a minor vestibular gland is lined by pseudostratified columnar epithelium composed of a layer of mucinous cells on the surface overlying several layers of basaloid cells.

small proportion of urethral adenocarcinomas that are PSA-secreting adenocarcinomas. Cohen et al. by contrast, examined two cystourethrectomy specimens in females, and found mucinous glands, but none of these were prostatic acid phosphatase-secreting (15). Further studies into the types, frequency, and location of urethral/ paraurethral glands and mucinous glands are needed.

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