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repro/GU > 225b prostate pathology > Flashcards

225b prostate pathology Flashcards

1
Q

prostatic base vs apex

A 
base = bladder side
apex = pelvic floor musculature
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2
Q

prostatic base vs apex

A 
base = bladder side
apex = pelvic floor musculature
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3
Q

prostate zone

A 
PZ = peripheral, cancer zone
CZ = central, cone around ejectultory duct  
TZ = transitional, BPH, around periurtheral zone
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4
Q

normal prostate histo

A

normal glands have big opening with irregular contours

2 cell layers:
basal cells - outer layer with support role, myo fxn too

acinar cells - inner cells, light stain, low N/C ratio, no nucleoli

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5
Q

prostate fxn

A

adds nutrients to sperm to form semen
liquefies semen via enzymes
conduit for urine

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6
Q

PSA

A

secreted by prostatic acinar and ductal epi cells (not basal cells)

glycoproteins (Serine protease), transcription regulated by androgen (affects PSA levels)

fxn - liquefies semen

not cancer specific, prostate specific (elevated in inflammation, cancer, BPH, etc)

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7
Q

prostatitis conditions

A

acute - PMNs

chronic a/bacterial - lymphocytes

granulomatous - histiocytes, mycobacteria treatment for bladder cancer, fungus

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8
Q

BPH - location and effects

A

occurs in transitional zone around peri-urethral

median lobe is from transition zone that gets very big form BPH

increases with age

can cause trabeculations and calculi

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9
Q

BPH

A

occurs in transitional zone around peri-urethral

increases with age

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10
Q

prostate zone

A 
PZ = peripheral, cancer zone
CZ = central, cone around ejectultory duct  
TZ = transitional, BPH, around periurtheral zone
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11
Q

normal prostate histo

A

normal glands have big opening with irregular contours

2 cell layers:
basal cells - outer layer with support role, myo fxn too

acinar cells - inner cells, light stain, low N/C ratio, no nucleoli

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12
Q

prostate fxn

A

adds nutrients to sperm to form semen
liquefies semen via enzymes
conduit for urine

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13
Q

PSA

A

secreted by prostatic acinar and ductal epi cells (not basal cells)

glycoproteins (Serine protease), transcription regulated by androgen (affects PSA levels)

fxn - liquefies semen

not cancer specific, prostate specific (elevated in inflammation, cancer, BPH, etc)

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14
Q

infections of prostate

A

prostatitis - clinical dx + culture (no biopsy)

normal see inflammation in prostate, doesn’t represent clinical usefulness

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15
Q

prostatitis conditions

A

acute - PMNs

chronic bacterial - UTI; chronic is lymphocytes

chornic abacterial

granulomatous - histiocytes, mycobacteria treatment for bladder cancer, fungus

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16
Q

BPH

A

occurs in transitional zone around peri-urethral

increases with age

17
Q

BPH hormones

A

DHT for stroma cells

T for epithelial cells

18
Q

BPH histo

A

nodular hyperplasia of glands and stroma

2 cell layers of basal + epi, stroma –> large caliber of glands

examine to exclude cancers

19
Q

PC gleason grading

A

based on architecture, ignores cytologic features

combines 1st and 2nd most common patterns

shape of glands are important, not cytological (1-5 x 2)

3=small round glands that aren’t fused – 4 is fused without stroma; 5=sheets of cells, necrosis

20
Q

PC types

A

acinar adenocarcinoma - vast majority of PC cases

21
Q

PC risks

A

Age, AA, Family Hx, Western diet

22
Q

PC precursor lesion

A

develops several decades before PC

PIN - prostatic intraepi neoplasia (high grade and low grade)

resemble cancer but retains basal cell layer (hasn’t invaded BM)

PC loses basal cells and invades BM

23
Q

PC path evaluation (transrectal needle biopsy and prostatectomy)

A

biopsy - very small samples –> sampling error (20% false negative rate)

24
Q

seminal vesicles locaiton

A

posterior and superior of prostate

25
Q

PC histo

A 
lumen is more round and smaller
no basal cells
nuclear enlargement
nucleoli
high N/C ratio 
dark cytoplasm
26
Q

PC immunohisto stains

A

racemase –> HGPIN or cancer

p63 –> nuclear protein in basal cells (HGPIN not PC)

27
Q

PC gleason grading

A

based on architecture, ignores cytologic features

combines 1st and 2nd most common patterns

shape of glands are important, not cytological (1-5 x 2)

3=small round glands that aren’t fused – 4 is fused without stroma; 5=sheets of cells, necrosis

28
Q

where does PC spread?

A

vertebral bodies –> bones

Osteoblastic metastases

29
Q

lichen sclerosis

A

associated with SCC

30
Q

HSV penis

A

mutlple shallow nodules

w/ multinucleated cells

31
Q

molluscum contaginosum

A

mutple flesh colored papules with central umblicaiton

32
Q

condyloma cuminatum

A 
genital warts - ofen multifocal 
HPV 6/11
koliocytes - perinuclear halo with raisin type nuclei
NO BASAL LAYER INVOLVEMENT  
recur but dont progress
33
Q

penile intraepithelial neoplasia

A

HPV 16, 18
E6–I p53, e7–I Rb
koliocytosis + BASAL CELL PROLIFERATION

34
Q

bowen, erthyroplasia, bowenoid and SCC

A

?

repro/GU (33 decks)

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