CP33 - UROGENITAL PATHOLOGY Flashcards
what are other names for enlargement of the prostate?
nodular hyperpleasia
benign prostatic hyperplasia
what enlargement of the prostate consist?
consists of overgrowth of the epithelium and fibromuscular tissue of the transition zone and periuretheral area
what are known as LUTS?
Lower Urinary Tract Symptoms - symptoms caused by interfering with muscular sphincteric function and by obstruction of urine flow through prostatic urethra
what are some examples of LUTS?
urgency, difficulty in starting urination, diminished stream size and force, increased frequency, incomplete bladder emptying, and nocturia.
what is nocturia
excessive urination during the night
what are the different zones of prostate?
central, peripherial, transitional and periurethral zone
what are the 3 pathologic stages of nodular hyperplasia?
nodule formation
diffuse enlargement of transition zone and periurethral tissue
enlargement of nodules
what is the aetiology of nodular hyperplasia
It is believed that the main component of the “hyperplastic” process is impaired cell death. It has been proposed that there is an overall reduction of the rate of cell death, resulting in the accumulation of senescent cells in the prostate.
In keeping with this androgens (mainly DHT) which are required for the development of BPH, can not only increase cellular proliferation, but also inhibit cell death.
what are some risk factors for prostate carcinoma
> 40 yrs african FH hormone levels environmental influences (increased consumptions of fats)
androgens - important role
what are the treatment for prostatic cancer?
surgery, radiation therapy and hormonal manipulations
radial prostatectomy
external-beam radiation therapy, interstitial radition therapy
what does androgens do in prostate cancer?
maintaining the growth and survival of prostate cancer cells
which genes have a 20-fold increased risk of prostate cancer?
BRCA2
which race has the highest risk?
Northern european and lowest in asian and african descent
what are the aetiology of testicular germ cell tumours?
Prior TGCT in the contralateral testicle
Cryptorchidism
Impaired spermatogenesis
Inguinal hernia
Hydrocele
Disorders of sex development
Prior testicular biopsy
Testicular atrophy
what are the difference between seminoma and teratoma in terms of occurrence period
seminoma - 35-45
teratoma - 1st and 2nd decades of life
what are the difference between seminoma and teratoma in terms of presentation
seminoma - testicular enlargement, presence of tumour markers
teratoma - gradual enlargement, pure form does not secrete tumour markers
what is the name for inflammation of testis
epididymoorchitis
what is idiopathic granulomatous orchitis
Typically in older adults, often with associated symptoms of UTI, trauma, or flu-like illness
testis becomes swollen, painful, and tender initially but later may have a residual mass indistinguishable from a neoplasm, prompting orchiectomy.
how does sarcoidosis present in the testis?
Sarcoidosis can affect the testis, and can mimic malignancy, particularly if accompanied by radiologic pulmonary abnormalities
how does Malakoplakia of testis present in the testis?
Malakoplakia may affect only the testis, or less commonly, both testis and epididymis, resulting in formation of soft yellow, tan, or brown nodules that replace normal testicular parenchyma
how does myofibroblastic pseufotumour of testis present in the testis?
An atypical inflammatory and myofibroblastic reaction with fasciitis-like large cells.
how does Sperm Granuloma present in the testis?
An exuberant foreign body giant cell reaction to extravasated sperm, and occurs in up to 42% of patients after vasectomy and 2.5% of routine autopsies. Patients may have no symptoms, but often present with a history of pain and swelling of the upper pole of the epididymis, spermatic cord, and, rarely, the testis.
how does tuberculous orchitis present in the testis?
Patients usually present with painless scrotal swelling, but other signs and symptoms include unilateral or bilateral mass, infertility, and scrotal fistula.
Caseating granulomatous inflammation is prominent, with fibrous thickening and enlargement of the epididymis and adjacent structures.
what is cryptorchidism
abscess of one or both testis from the scrotum
how does cryptorchidism present
These testes most frequently are found in the inguinal canal or upper scrotum; arrest within the abdomen is less frequent.
Congenital: caused by anomalies in anatomic development or hormonal mechanisms involved in testicular descent.
Complications: Testicular atrophy, infertility, carcinoma (TGCTs)
