11: Pathology 3 Flashcards
What names are given to SCC-in-situ of the penis?
Erythroplasia of Queryat (glans and shaft)
Bowen’s disease (everything else)
What does SCC-in-situ of the penis look like?
Red, velvety plaque
SCC occurs in men who are ___.
uncircumcised
What virus is associated with SCC of the penis?
HPV type 16
Is SCC of the penis common in the UK?
No
What are risk factors for penile SCC?
Aged 20 - 35
Uncircumcised
HPV type 16
Poor hygiene
What is a common disorder affecting men over the age of 50?
Benign prostatic hyperplasia (BPH)
What causes BPH?
Imbalance between testosterone (decreases) and oestrogen (excess) levels
What urinary problems does BPH cause?
Urine retention
Hesitancy
Slow flow
Overflow incontinence
What group of symptoms are collectively called prostatism?
Hesitancy
Poor flow
Overflow incontinence
Urine retention
Hesitancy, slow flow and incontinence are collectively called ___.
prostatism
What happens to the bladder muscle in BPH?
Hypertrophy
Forms diverticulae (which stones can lodge in)
What are complications caused by the obstruction in BPH?
Hydronephrosis
UTI
How is BPH managed?
Alpha blockers
5alpha reductase inhibitors (finasteride)
Surgery
Does BPH lead to prostate cancer?
Not for sure
But people who develop prostate cancer CAN have BPH
What does BPH look like on biopsy?
Stromal and glandular hypertrophy
What is the most common cancer in men in the UK?
Prostate cancer
When do men tend to get prostate cancer?
50+
People with a ___ history of prostate cancer are more likely to develop it.
family history
Which local organs can prostate cancer spread to?
Urethra
Bladder
Rectum
What is prostate cancer notorious for spreading to?
Bone
What process does metastatic prostate cancer cause in bone?
Osteosclerosis
whereas most other cancers cause osteolysis
What are the investigations for
a) initial
b) suspected metastatic
prostate cancer?
a) PR exam, blood PSA, prostate biopsy
b) CT everything, bone scans
Does an elevated PSA mean prostate cancer?
No, lots of other reasons
But if gradually, consistently increasing then probably prostate cancer
Which
a) drugs
b) surgery
are used to treat prostate cancer?
a) LHRH agonists, anti-androgen
b) Prostatectomy
What is the prognosis of testicular cancer?
Very good
What is a big risk factor for testicular cancer?
Undescended testes
Is testicular cancer painful?
No, usually presents as PAINLESS TESTICULAR LUMP
What is an endocrine symptom associated with testicular cancer?
Gynaechomastia
What are two germ cell tumours of the testicle?
Seminoma
Teratoma
Which germ cell tumour of the testicle is most common?
Seminoma
What do seminomas look like on biopsy?
Solid, homogenous, pale
(like a potato)
What cells are present in the interstitium of seminomas?
Lymphocytes
Which treatment are seminomas sensitive to?
Radiotherapy
What type of germ cell tumour makes up 1/3rd of testicular cancers?
Teratoma
group of different cancers
What is the appearance of teratomas on biopsy?
Solid
Cystic
Haemorrhage
Necrosis
Why are germ cell tumours given that name?
Contain cells derived from all three germ layers
What are markers of testicular cancer?
AFP
hCG
LDH
Apart from being markers of testicular cancer, what are AFP and hCG also notable for?
AFP - marker for hepatocellular carcinoma
hCG - pregnancy test
Seminomas and teratomas both produce ___ and ___.
Seminomas don’t produce ___.
both produce hCG and LDH
seminomas don’t produce AFP
