CH14 - Male Genital System Pathology Flashcards
What is the hypospadias?
Opening of urethra on inferior surface of penis
What is hypospadias due to?
failure of the urethral folds to dose
What is epispadias?
opening of urethra on superior surface of penis
What is epispadias due to?
abnormal positioning of the genital tubercle
What is epispadias associated with?
bladder exstrophy
What is condyloma acuminatum?
Benign warty growth on genital skin
What is condyloma acuminatum due to?
HPV type 6 or 11; characterized by koilocytic change
What is lymphogranuloma venereum?
Necrotizing granulomatous inflammation of the inguinal lymphatics and lymph nodes
What is lymphogranuloma venereum caused by?
sexually transmitted disease caused by Chlamydia trachomatis (serotypes L1-L3)
What eventually happens to lymphogranuloma venereum?
it heals with fibrosis; perianal involvement may result in rectal stricture
What is squamous cell carcinoma for the penis?
Malignant proliferation of squamous cells of penile skin
What are the risk factors for squamous cell carcinoma of the penis?
1) high risk HPV (2/3 of cases) 2) Lack of circumcision
Why is a lack of circumcision a risk factor for squamous cell carcinoma of the penis?
foreskin acts as a nidus for inflammation and irritation if not properly maintained
<p>
| In squamous cell carcinoma of the penis what are the precursor in situ lesions?</p>
<p>
| 1) Bowen disease 2) Erythroplasia of Queyrat 3) Bowenoid papulosis (only CIS with no predisposition for invasion)</p>
What is Bowen disease?
in situ carcinoma of the penile shaft or scrotum that presents as leukoplakia
What is erythroplasia of queyrat?
in situ carcinoma on the glans that presents as erythroplakia
What is bowenoid papulosis?
in situ carcinoma that presents as multiple reddish papules
In whom is bowenoid papulosis seen?
Seen in younger patients (40s) relative to Bowen disease and erythroplasia of Queyrat
How invasive is bowenoid papulosis?
Does not progress to invasive carcinoma
What is cryptorchidism?
Failure of testicle to descend into the scrotal sac
Where do the testicles normally develop?
in the abdomen and then descend into the scrotal sac as the fetus grows.
What is the most common congenital male reproductive abnormality and how often is it seen?
Cryptorchidism and is seen in 1% of male infants
What is orchiopexy?
Operation to bring undescended testicle into scrotum
What happens in most cases of cryptorchidism?
most cases resolve spontaneously; otherwise, orchiopexy is performed before 2 years of age.
What are the complications for cryptorchidism?
they include testicular atrophy with infertility and increased risk for seminoma.
What is orchitis?
Inflammation of the testicle
What are the causes for orchitis?
1) Chlamydia trachomatis (serotypes D-K) or Neisseria gonorrhoeae 2) Escherichia coli and Pseadomonas 3) mumps virus 4) autoimmune orchitis
In whom is orchitis caused by Chlamydia trachomatis (serotypes D-K) or Neisseria gonorrhoeae seen in and what happens as a result?
young adults. Increased risk of sterility, but libido is not affected because Leydig cells are spared.
In whom is orchitis caused by Escherichia coli and Pseadomonas seen in and what happens as a result?
older adults and what results is that urinary tract infection pathogens spread into the reproductive tract.
In whom is orchitis caused by the mumps virus seen and what is the result?
Seen in teenage males and there is an increased risk for infertility; testicular inflammation is usually not seen in children < 10 years old.
What is autoimmune orchitis characterized by?
granulomas involving the seminiferous tubules
What is testicular torsion?
twisting of the spermatic cord; thin-walled veins become obstructed leading to congestion and hemorrhagic infarction
What is testicular torsion usually due to?
congenital failure of testes to attach to the inner lining of the scrotum via the processus vaginalis
How does testicular torsion present?
in adolescents with sudden testicular pain and absent cremasteric reflex
What is a varicocele?
dilation of the spermatic vein due to impaired drainage
What does a varicocele present as?
scrotal swelling with a bag of worms appearance
To what side does the varicocele present?
usually left sided;
Why does a varicocele present as left sided?
Because the left testicular vein drains into the left renal vein, while the right testicular vein drains directly into the IVC.
What is the varicocele associated with?
left-sided renal cell carcinoma; RCC often invades the renal vein.
In whom is the varicocele seen?
in a large percentage of infertile males
What is a hydrocele?
Fluid collection within the tunica vaginalis
What is the tunica vaginalis?
it is a serous membrane that covers the testicle as well as the internal surface of the scrotum.
What is the tunica vaginalis associated with?
incomplete closure of the processus vaginalis leading to communication with the peritoneal cavity (infants) or blockage of lymphatic drainage (adults)
How does the hydrocele present?
as scrotal swelling that can be transluminated
From where do testicular tumors arise?
from germ cells or sex cord-stroma
What do testicular tumors present as?
a firm, painless testicular mass that cannot be transluminated
When are testicular tumors biopsied?
usually not biopsied due to risk of seeding the scrotum; removed via radical orchiectomy
Are testicular tumors benign or malignant?
Most testicular tumors are malignant germ cell tumors.
What are the testicular germ cell tumors?
Seminoma, Nonseminoma, embryonal carcinoma, Volc sac tumor, choriocarcinoma, teratoma, milted germ cells
What is the most common type of testicular tumor?
Germ cell tumors (> 95% of cases)
In whom do the most common type of testicular tumor usually occur?
between 15-40 years of age
What are the risk factors for germ cell testicular tumors?
include cryptorchidism and Klinefelter syndrome
What are germ cell testicular tumors divided into?
seminoma and nonseminoma
What are seminomas?
It is 55% of testicular tumor cases and are highly responsive to radiotherapy, metastasize late, and have an excellent prognosis,