Kellen Flashcards
Leydig Cell Tumor
2 peaks: kids and adults (80%)
benign - testicular swelling
may produce androgens, estrogens, corticosteroids
gynecomastia or precocious puberty = presenting features
REINKE crystals - lipofuscin, intracytoplasmic
Sertoli Cell Tumor
clinically silent
trabeculae forming cordlike structures in fibrous stroma
Spermatocele
cystic semen in efferent and rete testis ducts
DHT rxn?
T –> DHT via 5 alpha reductase
DHT binds to nulcear androgen receptor – increased GFs and FBGF 1,2, 7 and TGF beta.
increased stromal proliferation and decreased death of epithelial cells
How to treat BPH?
alpha blockers - relaxes bladder neck, decreases prostate SM tone
5 alpha reductase inhibitors - inhibits DHT synthesis
5 alpha reductase
located in STROMAL cells - stromal cells responsible for androgen dependent prostatic growth of epithelial cells
normal PSA
0-4
chronic abacterial prostatitis
painful ejaculations
Free PSA
Cancer makes BOUND PSA. decreased free PSA = cancer
Adenomatoid Tumor
mesothelial origin benign
IHC of prostate cancer
no CK, p63
presence of AMACR
AR gene
CAG repeats - shorter = highest sensitivity to androgens, blacks
Prostate Cancer Mets
obturator, para-aortic
Hematogenous: axial skeleton (osteoBLASTIC)
What does the PSA bind to with cancer?
alpha1- chymotrypsin
What cytokine is responsible for T cell differentiation in Tb?
IL-12
Sarcoidosis
High CD4 - making IFN-gamma and IL-2 locally
No NK cells
lots and lots of Il-8, TNF
Schaumann bodies & asteroid inclusions
lymph node enlargement, eye involvement, erythema nodosum
Acrocentric chromosomes
13-15, 21-22
Tay Sachs
hexosaminosidase A on chrom 15 - buildup of GM2 ganglioside
Gaucher
Beta-glucocerebrosidase on chrom 1 - buildup of glucocerebroside
Neimann Pick
syphingomyelinase gene on chrom 11
Krabbe
AR deficiency of galactosylceramidase –> shunted to production of galactosylsphingosine = cytotoxic
Metachromatic leukodystrophy
AR deficiency in arylsulfatase A – sulfatide accumulation
Adrenoleukodystrophy
X linked - mutations in ABCD1 - peroxisome
perivascular lymphocytic infiltrates
Neuromyelitis Optica (Devic’s)
bilateral optic neuritis and spinal cord demyelination
Abs against AQP4
Concentric Sclerosis of Balo
borderline form of MS - primary progressive with better prognosis
Acute Disseminated Encephalomyelitis
increased lipid-laden macrophages
all lesions are similar - monophonic
1-2 weeks after measles, mumps, flu; post rabies or smallpox vaccine
perivascular lymphocytic infiltrates with demyelination
gray/white junction
central pontine myelinolysis
rapid correction of hyponatremia
rapid increase in extracellular tonicity draws water out of cells
most common places for atherosclerotic plaque?
MCA, basilar
hypertension affects?
BG, pons, cerebellum
Lipohyalinosis
macrophages invade wall of artery (result of HTN)
Hypertensive Vascular changes lead to what?
Charcot Bouchard Aneurysms - intracerebral hemorrhages
Saccular Aneurysm
MCA &ICA, ACommA
most common cause of SA hemorrhage
Absene of SM, IEL
Fusiform Aneurysm
tortuous BASILAR artery, advanced atherosclerosis, RARELY RUPTURE
AV Malformation
posterior branches of MCA
seizures (no capillary in middle)
Cerebral Amyloid Angiopathy
hemorrhage into SUBCORTICAL WHITE matter - lobar hemorrhages
Embolic Stroke
hemorrhagic
Thrombotic STROKE
pale - thrombus keeps reforming
reperfusion looks like what?
punctate hemorrhages
bone marrow embolization?
widespread white matter hemorrhages
loss of chr 22
meningiomas, schwannomas
loss of chr 10
glioblastomas
endometrial polyp
responds to estrogen, not progesterone - Tamoxifen association
endometrial hyperplasia
increase in glands rleative to storm secondary to estrogen - PTEN tumor suppressor gene
most common female genital cancer in USA?
endometrial adenocarcinoma - presents with post-menopausal bleeding
endometrial adenocarcinoma type I
60 yo associated w/ hyperplasia (unopposed estrogen) - well differentiated more solid = WORSE prognosis PTEN, KRAS, microsatellite instability direct extension, lymphatics
endometrial adenocarcinoma type II
older
endometrial ATROPHY
serous, clear cell - poorly differentiated
p53 - intraperitoneal metastasis
endometrial stromal sarcoma
stroma in MYOMETRIUM
cleft around tumor
Leiomyoma Locations
- Submucosal - bleeding
- Intramural - asymptomatic
- Subserosal - may undergo torsion
leiomyosarcoma mets?
hematogenous - lung, bone, brain
vulva SCC
- basaloid/warty - HPV - classic VIN
2. keratinizing - HPV NEGATIVE - VIN simplex
Paget’s
CK
CEA
EMA
PAS
Melanoma
melan A
S100
Follicular Cyst
lined by GRANULOSA cells - can produce estrogens
PCOS
increased risk of endometrial carcinoma and breast cancer
theca interna hyperplasia
Call Exner Bodies
coffee bean nuclei in granulosa cell tumors
Granulosa Cell Tumor
inhibin positive
