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Cardio > Histopathology Male Genital System 1 and 2 > Flashcards

Histopathology Male Genital System 1 and 2 Flashcards

1
Q

Spermatoceole

A

Benign epithelial cyst of epididimus

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2
Q

Varicocoele

A

Dilated blood vessels (tortuous)

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3
Q

Hydrocoele

A

Accumulation of serous fluid in body cavity (ascites or testicular)

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4
Q

Cryptochidism → Definition

A

Permanent retention of testis outside the scrotum

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5
Q

Cryptochidism → Prevalence

A

Occurs in 1% of boys

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6
Q

Cryptochidism → Presentation

A

Must are idiopathic and unilateral

If bilateral, can results in sterility

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7
Q

Cryptochidism → Risks associated

A

30-4- x more risk of developing GCT
If a cryptorchid testis is surgically placed in the scrotum, it may still develop a germ cell neoplasm especially if operated after 6 years of age

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8
Q

Atrophy →Can be secondary to

A
  • Cryptochidism
  • Inflammation – mumps
  • Oestrogens (Cirrhosis and hormonal therapy for PCa)
  • Chemotherapy, particularly cyclophosphamide (cause cell death as rapidly dividing cells)
  • Radiation exposure
  • Testicular regression syndrome (possibly secondary to infarction in-utero)
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9
Q

Male Infertility → Causes can be grouped into three categories

A
  • Pre testicular – extra-testicular endocrine disorder
  • Testicular – all the causes of atrophy
  • Post testicular – obstruction of the ducts – can be located by surgery
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10
Q

Mumps Orchitis → Epi

A

Mumps usually occurs in children involving parotid gland.

In adults, about 25% of the cases are complicated by orchitis

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11
Q

Mumps Orchitis → Definition

A

The testis is enlarged and very tender due to stretching of the tunica albugenia
In many cases, however the testis becomes atrophic and if bilateral can lead to infertility.

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12
Q

Mumps Orchitis → Types

A

Idiopathic Granulomatous Orchitis

Syphillic Orchitis

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13
Q

Mumps Orchitis → Idiopathic Granulomatous Orchitis

A

Uncommon causes of unilateral testicular enlargement in middle-aged men

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14
Q

Mumps Orchitis → Idiopathic Granulomatous Orchitis microscopically

A

Granulomas are centred on the tubules and into the interstitium

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15
Q

Mumps Orchitis → Idiopathic Granulomatous Orchitis possible aetiology

A

Includes reaction to estravasated sperms (Rupture of seminiferous tubules stimulates an immune response.

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16
Q

Mumps Orchitis → Syphillic Orchitis

A

Now rarely seen
Was common site of development of Gumma
M/s granulomatous inflammation with central necrosis

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17
Q

Mumps Orchitis → Features

A

1o Ulcer
2ndry Wafty lesions mucocutaneous junction
3 o Involves CVS – artic aneurysm/spial dorsal column → neurosyphilis

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18
Q

Testicular Tumours → Peak incidence

A

15-34 years
Most common tumour of male in this age group
Accounts for less than 1% of all cancer deaths in UK

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19
Q

Testicular Tumours → Can be classified into:

A
  1. Germ cell tumour (90%)
  2. Sex-cord stromal tumours (sertoli and leydig cells)
  3. Mixed germ cell sex cord stromal tumours
  4. Primary tumours not specific to the testis e.g. lymphoma
  5. Metastatic tumours
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20
Q

Germ Cell Tumours → Description

A

Most testicular GCT are malignant

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21
Q

Germ Cell Tumours → Derived from

A

Germ cells, therefore able to differentiate towards any embryonic or extraembryonic tissue.

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22
Q

Germ Cell Tumours → Can present with

A
  • Painless unilateral enlargement of testis
  • Secondary hydrocele
  • Symptoms from metasteses
  • Retroperitoneal mass
  • Gynaecomastia
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23
Q

Germ Cell Tumours → Risk Factors

A

• Cryptorchidism – higher the location greater the risk

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24
Q

Germ Cell Tumours → Genetic predisposition

A
  • Sibs have 10-fold high risk

* Blacks in Africa have very low incidence

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25
Q

Germ Cell Tumours → Testicular dysgenesis

A

Testicular feminisation

Klinefelter syndrome

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26
Q

Germ Cell Tumours → Cytogenic changes

A

Involving chromosome 12 and 1 (isochromosome of short arm of chromosome 12 – in 90%)

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27
Q

Germ Cell Tumours → Classification

A

In situ

Invasive

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28
Q

Germ Cell Tumours → In situ

A

Intratubular Germ cell Neoplasia

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29
Q

Germ Cell Tumours → Invasive

A

Seminoma
Non seminomatous Germ cell Tumours
Mixed

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30
Q

Germ Cell Tumours → Non seminomatous germ cell tumours types

A

Embryonal Carcinoma
Yolk sac tumour
Choriocarcinoma
Teratoma

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31
Q

Germ Cell Tumours → Intratubular germ cell Neoplasia

A
  • In situ stage
  • Proliferation of neoplastic germ cells within seminiferous tubules
  • Upto 80% of GCT show ITGCN in the adjacent tissue.
  • Sometimes seen in the biopsy performed for the study of infertility or cryptochidism
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32
Q

Germ Cell Tumours → Seminoma

A

• Commonest type of germ cell tumour
• Main sub-types includes
→ Classical 95%
→ Spermocytic

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33
Q

Germ Cell Tumours → Classical seminoma with histological appearance

A

Commonest sub-type
Peak in 4th decade
m/s sheets of rounded cells with clear cytoplasm and variable lymphocytic infiltrate in the stroma

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34
Q

Spermatocytic Seminoma

A

Accounts for 3-5% of all seminomas
Occurs in older age group
M/s mixed population of small intermediate and giant cells with increased mitotic rate

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35
Q

Spermatocytic Seminoma prognosis

A

Excellent

36
Q

Embryonal Carcinoma: Epi

A

Mostly in 20-30 years age group

37
Q

Embryonal Carcinoma: Description

A

More aggressive than seminoma

38
Q

Embryonal Carcinoma: M/S

A

The cells are anaplastic and arranged in glandular, alveolar, solid or papillary growth patterns.

39
Q

Embryonal Carcinoma: Usually associated with

A

Other germ cell tumour, pure form constitutes only 3% of GCT

40
Q

Yolk sac Tumours → Epi

A

In children pure form, most common GCT in infants and children up to 3 yrs of age, good prognosis.

41
Q

Yolk sac Tumours → In adults associated with

A

Embryonal carcinoma

42
Q

Yolk sac Tumours → Characteristic structures

A

Schiller-Duval bodies formed by a perivascular layer of tumour cells.

43
Q

Yolk sac Tumours → Serum shows

A

Levels of AFP are raised and the neoplastic cells are positive for AFP

44
Q

Choriocarcinoma: Incidence

A

Only 0.3% occurs in pure form whereas 1.5% of NSGCT tumours habe choriocarcinoma component.

45
Q

Choriocarcinoma: Composed of both

A

Cyto and syncitiotrophoblasts – multinucleated

46
Q

Choriocarcinoma: Serum

A

Raised serum HCG levels

47
Q

Choriocarcinoma: Prognosis

A

Highly malignant

48
Q

Teratoma → Differentiation

A

Can differentiate into any of the three germ cell layers

49
Q

Teratoma → These tumours can have

A

Mature 9adult type) tissue – TD

Immature (foetal type) tissue

50
Q

Teratoma → Pure teratoma (TD) 2nd common in children prognosis

A

Good

51
Q

Teratoma → Adult poor form prognosis

A

Only 2-3% treated as malignant as they have metastatic potential.

52
Q

Mixed Tumours → Prevalence

A

14% of all testicular GCT

53
Q

Mixed Tumours → Description

A

Various combination occurs including seminoma and NSGCT

54
Q

Mixed Tumours → Treated as

A

NSGCT

55
Q

Dissemination → Description

A

Direct spread to rete testis and epididymis

56
Q

Dissemination → Spread via

A
  • The Lymphatics to para-aortic lymph nodes and then to mediastonal lymph nodes.
  • Blood to lung, liver and bone (teratoma).
57
Q

Dissemination → Prognosis of Germ cell Tumour

A

Seminoma v/s NSGCT

58
Q

Dissemination → Stage 1

A

Confined to the testis

59
Q

Dissemination → Stage II

A

Testis + para-aortic lymph nodes

60
Q

Dissemination → Stage III

A

Testis + mediastinal and/or supraclavicular LNs

61
Q

Dissemination → Stage IV

A

Visceral metastasis

62
Q

Prostate → Anatomy

A

Surrounds the bladder neck and proximal urethra

63
Q

Prostate → Normal weight

A

Approx. 20 mg

64
Q

Prostate → Also divded into

A

Inner (periurethral) and the outer (cortical) zone

65
Q

Prostate →Inner Zone

A

Nodular hyperplasia

66
Q

Prostate → Outer zone

A

Carcinoma

67
Q

Prostate → M/s

A

The glandular component is divided into ducts and acini

68
Q

Prostate → Glandular component cellular component

A

Two cell layers

69
Q

Prostate → The Stroma is

A

Fibromuscular

70
Q

Prostrate Inflammation →Acute and Chronic bacterial prostatitis

A

Occurs secondary to UTI
Prostatic secretions are positive for bacterial culture
Difficult to treat chronic prostatitis

71
Q

Prostrate Inflammation → Chronic abacterial prostatisis

A

Most common form

Prostatic secretion contains leukocytes but negative for bacterial culture

72
Q

Nodular Hyperplasia → Prevalence

A

Extremely common in men over the age of 50 years (70% by the age of 60 years)

73
Q

Nodular Hyperplasia → Involves

A

Periurethral region of the prostate

74
Q

Nodular Hyperplasia → Results in

A

Urinary Retention

75
Q

Nodular Hyperplasia → Caused by

A

Androgens (dihydrotestosterone DHT)

76
Q

Nodular Hyperplasia → Increased weight

A

60 to 100 mgs

77
Q

Nodular Hyperplasia →M/s

A

There is increase in glandular and stromal component in both

78
Q

Nodular Hyperplasia → 5 alpha reductase

A

Testosterone converted to DHT (more potent)

79
Q

Carcinoma of Prostate →Prevalence

A

Commonest form of cancer in males but second commonest cause of death – die w/ cancer not because of it.

80
Q

Carcinoma of Prostate → Incidence

A

Increased incidence after the age of 50 years

81
Q

Carcinoma of Prostate →Incidence

A

Blacks> Whites> Asian

82
Q

Carcinoma of Prostate → Etiology

A

Multifactorial
• Hormone – androgen receptor (large no. of receptors in these cells)
• Genetic, susceptibility genes 1q24-25, 1st degree relatives
• Fat consumption
• Lycopene in tomatoes (protective)

83
Q

Premalignant lesions associated with Carcinoma of prostate

A

59-100% of prostatic adenocarcinoma in radical prostatectomy specimens

84
Q

Carcinoma of Prostate → M/S

A

Adenocarcinoma i.e. tumour forms small glandular structures lined by layer of cells

85
Q

Carcinoma of Prostate → Grading

A

Glessons score depending up to the growth patterns.

86
Q

Carcinoma of Prostate → Prevalence Staging

A

A: not palpable
Stage B Palpable, confined to prostate
Stage C Extracapsular extension
Stage D Metastatic

87
Q

Carcinoma of Prostate → Diagnosis

A

Raised PSA level, range according to the age
Digital PR examination
Imaging Biopsy

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