Exam 2 - Male Flashcards
Single plaque located on the shaft
Localized to epithelium
No stromal involvement
Bowen disease/Squamous cell carcinoma in situ
Cancer on Prepuce or glans
Erythroplasia of Queyrat/Squamous cell carcinoma in situ
Crusted, ulcerated raised lesion
Irregular margins
Prepuce or glans
Invasive squamous cell carcinoma
Most common cause of scrotal enlargement
Hydrocele
Absent scrotal ligament
can cause?
Testicular torsion
Inflammation of the epididymis
Reflux of contaminated urine through the prostatic urethra → ejaculatory duct
Cremasteric reflex is not altered
Epididymitis
Most common cancer 15-34 y/o (Painless, testicular enlargement)
Testicular Cancer
2 risks of testicular cancer
- Cryptorchidism 3-5X increased risk
2. Isochromosome short arm of 12, (i12p)
is noted for large nuclei with prominently staining nucleoli, large cells with clear cytoplasm, and a lack of spermatogenesis.
The precursor to most germ cell tumors of the testes.
Intratubular Germ Cell Neoplasia (IGCN)
Most common GCT (Germ Cell Tumor), not seen in infants
Adults (4th-5th decade)
Seminoma
Most common non-seminoma (GCT)
Adults (2nd to 3rd decade)
Embryonal carcinoma
Aggressive adult cancer (small palpable nodule(s); No test. enlargement)
Contain both syncytiotrophoblasts and cytotrophoblasts germ cells
Elevated hCG (100%)
Metastasis to lung and brain (5 year survival = 5%)
Choriocarcinomas
Contain somatic cells from all three germ layers (ectoderm, mesoderm, and endoderm
Teratoma
Infants/children (usually ≤2 yo)
Schiller-Duvall bodies
Elevated AFP (90%)
Yolk Sac Tumor
Most common disorder of prostate < 50 yo
3rd most common > 50 yo
Prostatitis
Excessive growth of the epithelium and stroma of the prostate
Transition zone of the prostate
BPH
3 steps of pathophysiology of BPH
1.Androgen driven excessive growth of prostatic epithelium and stroma
5DHT
- Androgens bind receptors and are translocated to nucleus
- Increased transcription of proliferative and anti-apoptotic genes
Most common cancer in adult men in the U.S.
Prostate cancer
These Start from HGPIN (high-grade prostatic intraepithelial neoplasia)
Adenocarcinomas (prostate cancer)
4 factors that are considered pathogenesis of prostate disorders
- Androgens/Androgen receptor
- Heritable mutations
- Somatic mutations
- Environment
Heredity prostate cancer 1 gene
RNaseL
-Germ-line mutation
1q24-q25 (HPC-1)
Enhancers for Myc
Long non-coding RNA’s
-Germ-line mutation
8q24 (African-Americans)
a latent ribonuclease that is activated by interferons in response to viral infection. The normal role of this is to degrade viral RNA inducing apoptosis as part of the innate immune response to viral infection.
RNaseL
is a gene that encodes for a nuclear transcription factor involved in cell cycle progression. The overexpression of the transcription factor results in the expression of proteins involved in cell proliferation.
Myc
6 causes of hydrocele
1.Congenital (< 2 yo) Patent processus vaginalis 2.Local trauma 3.Infections 4.Tumors 5.Radiotherapy 6.Idiopathic
Recognize the underlying mechanisms of epididymitis
- Sexually active men (14-35)
- Chlamydia trachomatis
- Neisseria gonorrheae
- E.coli - Older than 35
- Urinary tract obstructions
- E. coli - Mumps orchitis
- Fever, myalgia
- 3-5 days post parodititis - Histology
-Non-specific
>Tender, swollen
>Histology neutrophils
-Mumps
>Edematous, congested
lymphocytes
-Granulomatous
>TB
>Caseous Necrosis
Recall the association between cryptorchidism and testicular cancer
3-5X increased risk
Differentiate between germ cell tumors and stromal tumors of the testes
*Germ cell cancers (95%)
>>Seminomas (50%)
>>Non-seminomas
-Embryonal
-Choriocarcinoma
-Yolk sac tumors
-Teratomas
*Non-germ cell cancers (cord or stromal) – usually benign
»Sertoli
»Leydig
Identify the causes of prostatitis
1.Acute Bacterial >>Intraprostatic urinary reflux >>Ascending urethral infection >>Direct spread or lymphatic spread from rectum >>Hematogenous spread
2.Chronic Bacterial
»Recurrent UTI’s
»Prostatic stones
»Bladder outlet obstruction with reflux
3.Pelvic Pain Syndrome (non-bacterial)
4.Chronic, Non-bacterial
Inflammatory
5.Non-inflammatory
