Vaginal adenosis: diagnosis by palpation. (Letter)

A report of clinical experience takes issue with a previously published statement characterizing vaginal adenosis as having only a single clinical picture. 3 nulliparous patients (aged 20 25 and 26 years) were found on digital examination to have small submucosal nodules with overlying intact vaginal epithelium located in the anterior posterior and left lateral fornices rspectively. The biopsies showed positive mucin staining of the subepithelial glands that were lined by columnar epithelium. All 3 patients had normal Schiller straining of the vagina and no red areas that could have directed colposcopic biopsies. These lesions could only have been detected by palpation. Therefore it seems that colposcopy though of interest is by no means necessary for diagnosis; all suspicious vaginal lesions should be biopsied. Pelvic screening of girls exposed to diethylstilbestrol in utero should include not only inspection and Schiller staining but also palpation.