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life cycles test 1 > disease of testis and penis > Flashcards

disease of testis and penis Flashcards

1
Q

list the stages of sperm development

A

spermatogonia > primary spermatocytes (diploid) > secondary spermatocytes (haploid) > spermatids > spermatozoa

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2
Q

What is spermiogenesis

A

process of cytodifferentiation by which spermatids become spermatozoa

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3
Q

anatomy of tunica propria

A

surrounds the tubules. Composed of myofibroblasts and elastic fibers

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4
Q

anatomy of testis interstitial tissue

A

contains vessels, nerves, and Leydig cells (produces testosterone in response to LH)

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5
Q

anatomy of tunica vaginalis

A

outer layer of testis- derived from peritoneum during descent

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6
Q

histology of penile urethra

A

lined by transitional mucosa

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7
Q

histology of glans penis

A

covered by squamous mucosa

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8
Q

cryptorchidism- what is it

A

Congenital maldescent of one (75% of cases) or both (25%) testes. May be found anywhere along pathway of descent.

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9
Q

cryptorchidism histology

A

Atrophy begins as early as 2 years old. Germ cell development arrest, thickening of basement membrane and hyperplasia of Leydig cells, eventual hyaline replacement

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10
Q

cryptorchidism risks

A

risk of developing cancer in both the undescended testis plus the contralateral testis (less extent). Surgery may not reduce the risk

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11
Q

List causes of testicular atrophy

A

cryptorchidism, Atherosclerosis, Inflammation, Malnutrition, Hypopituitarism, Hormone therapy (prostate cancer), Klinefelter’s Syndrome

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12
Q

List congenital causes of male infertility

A

cryptorchidism, immotile cilia syndrome, anorchia, absent vas deferens

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13
Q

List acquired causes of male infertility

A

Torsion and infarction (traumatic/mechanical or vascular), varicocele, obstruction, inflammation

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14
Q

List hormonal abnormalities that cause male infertility

A

FHS, LH or GnRH deficiency

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15
Q

Klinefelters syndrome

A

Causes male infertility. 47, XXY. Tubular sclerosis with absence of elastic fibers. Leydig cell nodules (hyperplasia), elevated FSH/LH and decreased testosterone

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16
Q

causes of epididymitis and orchitis

A

Usually due to direct extension from urinary tract (vas deferens or lymphatics) and tends to effect epididymis first with subsequent orchitis.

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17
Q

compare causes of epididymitis and orchitis in children vs adults vs elderly

A

children: gram negative rods (urinary tract malformations). Sexually active adults: chlamydia trachomatis, N. gonorrhoeae. Elderly: enterobacteria.

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18
Q

epididymitis and orchitis histology

A

acute inflammation +/- abscesses

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19
Q

mumps orchitis histology

A

Mononuclear inflammatory infiltrate with interstitial edema +/- neutrophils

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20
Q

mumps orchitis presentation and consequences

A

unilateral in 70%. Occurs in pubertal or adult males with mumps (30%) usually subsequent to parotid involvement. Infertility is uncommon

21
Q

define varicocele

A

abnormal dilatation & tortuosity of veins in pampiniform plexus due to venous valve insufficiency

22
Q

Varicocele and infertility

A

Possibly an epiphenomenon, thermal effect, maturation arrest, hyperspermatogenesis and/or abnormal sperm morphology

23
Q

varicocele location

A

left side alone in 90%. Bilateral in 10%

24
Q

tuberculus orchitis presentation/ histology

A

Begins in epididymis and spreads to testes. Usually part of systemic dz. Caseating granulomas

25
Q

Syphilis presentation and histology

A

Involves testes first then epididymis. Diffuse mononuclear interstitial inflammation rich in plasma cells. Obliterative endarteritis +/- gummas (coagulative necrosis)

26
Q

Most tumors of testes are what kind of tumor? And who do they occur in?

A

germ cell tumors- occur in young men (15-35 years)

27
Q

list types of germ cell tumors

A

seminoma (comes from totipotent germ cell), spermatocytic seminoma, embryonal carcinoma, yolk sca (extraembryonic), choriocarcinoma, teratoma (embryonic), mixed

28
Q

Sx and predisposing factors of germ cell tumors

A

Sx: painless testicular enlargement. Predisposing factors: cryptorchidism (5X), genetic factors (family history-5X), dysgenesis (50X)

29
Q

Most common germ cell tumor and who gets it

A

seminoma- occurs in fourth decade

30
Q

seminoma macro and microscopic appearance

A

macro: homogeneous “fish flesh” appearance. Micro: uniform large, polygonal cells with distinct cell membrane, clear cytoplasm, central nucleus and prominent nucleolus. Fibrous septa with lymphocytic infiltration or granulomatous reaction. Uncommonly may be anaplastic with high mitotic counts. Can have syncytiotrophoblastic giant cells which produce hCG

31
Q

Seminoma prognosis

A

Good! Radiosensitive and chemosensitive.

32
Q

spermatocytic seminoma - population, histology, prognosis

A

Older men (>65yrs). Mixture of cells resembling primary and secondary spermatocytes in myxoid stroma. Good prognosis- Slow growing and rarely metastasizes

33
Q

embryonal carcinoma- macro and micro features, prognosis

A

More aggressive than seminomas. Usually found as small tumors in testes but has high potential for extension through tunica albuginea and into spermatic cord. Large, hyperchromatic, pleomorphic nuclei and indistinct cytoplasm – mitoses frequent. Glandular, trabecular, papillary arrangements

34
Q

embryonal carcinoma population and markers

A

Pure is rare, mixed is more common. Third decade. Markers: PLAP, placental lactogen, hCG

35
Q

Yolk sac tumor- population, histology, markers

A

Most common testicular tumor of infants and children. Loose or maze-like network of cells on thin
fibrovascular cords or microcystic / myxomatous. Marker: alpha-fetoprotein

36
Q

choriocarcinoma- histology, prognosis, markers

A

Placental differentiation – syncytiotrophoblast and cytotrophoblast. Aggressive, often metastasize. Chemosensitive but worse prognosis. Produce human chorionic gonadotropin – useful as marker

37
Q

Teratoma- prognosis, histology

A

good prognosis in children, variable in adult (considered malignant). Mature: heterogeneous differentiated elements including any combination of neural tissue; muscle; cartilage; bronchial, intestinal, squamous epithelium, etc. within loose stroma. Immature: incompletely differentiated elements of the three germ cell layers

38
Q

Testis cancer staging

A

stage I: confined to testis. Stage II: retroperitoneal nodes or below diaphragm. Stage III: outside retroperitoneal nodes or above diaphragm

39
Q

What kind of tumor is a Leydig cell tumor

A

sex cord stromal tumor

40
Q

Leydig cell tumor Sx and histology

A

May produce hormones (androgen, estrogen) – gynecomastia,precocious puberty. Characteristic granular eosinophilic cytoplasm & intracytoplasmic crystals. 90% are benign

41
Q

What kind of tumor is a sertoli cell tumor

A

sex-cord-stromal tumor. Uncommon

42
Q

what is condyloma acuminatum

A

“Genital wart” of the penis composed of papillary projections of connective tissue covered with thickened hyperplastic epithelium. Koilocytes – epithelial cells with atypical crinkled nuclei and large perinuclear halo – a characteristic of human papilloma virus infection

43
Q

What is verrucous carcinoma

A

A “giant condyloma” of the penis with the tendency for local invasion. Rarely metastasizes

44
Q

Bowns disease

A

squamous carcinoma in situ involving skin of genital region. Small percent progress to invasive squamous carcinoma. Associated with visceral cancers

45
Q

Erythroplasia of Queyrat

A

squamous carcinoma in situ involving mucosal surfaces of glans penis in noncircumsized men. Can progess to invasive carcinoma

46
Q

penile squamous carcinoma incidence and population

A

rare in US due to hygeine practices. Largely a dz of elderly. Blacks > whites. HPV type 16 and 18 implicated

47
Q

staging of penile squamous cell carcinoma

A

stage I: confined to glans or prepuce. Stage II: penile shaft. Stage III: operable inguinal node metastases. Stage IV: distant metastases

48
Q

grading of penile squamous cell carcinoma

A

grade I: keratinization, squamous perals, intercellular bridges. Grade II-III: nuclear atypia, mitotic activity. Grade IV: nuclear pleomorphism, necrosis, no keratin pearls

life cycles test 1 (19 decks)

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