Review Question - QID 213358

A 76-year-old woman presents to the clinic complaining of blood on her underwear. She denies any clear precipitating factor or trauma to the area, but 2 weeks ago she noticed some reddish-brown stains on her undergarments. This has been happening intermittently since then. She denies pain, abnormal discharge, abnormal odors, urinary symptoms, or gastrointestinal symptoms. Her past medical history is unremarkable and she has had regular pap smears, the most recent being 10 years ago. A pelvic examination is performed and a small protrusion from the vaginal wall is visualized. A vaginal biopsy is done and its results are shown in Figure A. Which of the following is associated with this patient’s condition?