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Pathology > Lower Urinary Tract and Male Genital Tract > Flashcards

Lower Urinary Tract and Male Genital Tract Flashcards

1
Q

MCC of hydronephrosis in infants and children

MALES
bilateral

A

Ureteropelvic junction obstruction

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2
Q

MC and most serious congenital anomaly of the urinary bladder d.t. predisposition to infection and scarring

A

Vesicoureteral Reflux

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3
Q

Chronic inflammation reaction secondary to acquired DEFECTS in PHAGOCYTE function

chronic bacterial infection
immunosuppression

A

MALAKOPLAKIA

soft, yellow, slightly raided mucosal plaques

HISTOLOGY:
foamy macrophages
MICHAELIS-GUTMANN BODIES

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4
Q

Malformation of urethral groove –> abnormal opening on the VENTRAL shaft

Seen in 5-a reductase deficiency

A

HYPOSPADIAS

ASSOCIATIONS:
inguinal hernia
cryptorchidism
chordee

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5
Q

Malformation of urethral groove –> abnormal opening on the DORSAL shaft

A

EPISPADIAS

ASSOCIATIONS:
exstrophy of bladder

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6
Q

Benign sexually transmitted wart caused by LOW risk HPVs

HPV 6 (more common) and 11

A

CONDYLOMA ACUMINATUM

HISTOLOGIC:
superficial hyperkeratosis and acanthosis
KOILOCYTES - perinuclear cytoplasmic vacuolization

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7
Q

Malignant squamous lesion CONFINED to the epithelium by an INTACT basement membrane

A

Squamous Carcinoma In situ - Penile Intraepithelial Neoplasia (PEIN)

HPV related - HPV 16
*Bowen disease

NON-HPV related
*balanitis xerotica obliterans
*(+) squamous differentiation

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8
Q

Squamous cell carcinoma of the penis usually originates in

A

glans or inner surface of the prepuce near the coronal sulcus

irregular, fungating cauliflower-like masses; flat, indurated lesions; or large verruciform/papillary tumors

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9
Q

Complete or partial failure of the intra-abdominal testes to descend into the scrotal sac

associated with testicular dysfunction

increased risk of testicular cancer

A

Cryptorchidism

UNILATERAL

INGUINAL CANAL - MC site of undescended testes

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10
Q

MC phase of arrest of Cryptorchidism

A

INGUINOSCROTAL (4th-7th mo AOG)

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11
Q

Current recommendations for orchiopexy to be performed at

A

6 to 12 months of age

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12
Q

This disorder, which appears to be reactive rather than
neoplastic, is characterized by HARD PENILE PLAQUES that result from the deposition of COLLAGEN in the connective tissue between the corpora cavernosa and the tunica albuginea

A

Peyronie Disease

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13
Q

Mimics testicular tumor

tender mass w/ or w/o fever

NON CASEATING GRANULOMAS in seminiferous tubules

A

Granulomatous (Autoimmune) Orchitis

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14
Q

Undifferentiated PeIN

OLDER men

PRECURSOR to INVASIVE CA

A

BOWEN DISEASE

shaft and scrotum - SOLITARY THICKENED, GRAY WHITE, opaque plaque

glans - VELVETY RED

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14
Q

Undifferentiated PeIN

OLDER men

PRECURSOR to INVASIVE CA

A

BOWEN DISEASE

shaft and scrotum - SOLITARY THICKENED, GRAY WHITE, opaque plaque

glans - VELVETY RED

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15
Q

True urologic emergency

Twisting of spermatic cord –> impaired venous drainage –> congestion –> hemorrhagic infarction

A

TESTICULAR TORSION

6 hrs - GOLDEN period

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16
Q

MCC of PAINLESS testicular enlargement

ANY testicular mass should be considered MALIGNANT unless proven otherwise

A

TESTICULAR TUMORS

Germ cell - 95%
Sex-Cord stromal - 5%

17
Q

Most important associated condition in GERM CELL TUMORS

A

Cryptorchidism

18
Q

Germ Cell Tumors Classification

A

SEMINOMATOUS - BETTER prognosis
NON-SEMINOMATOUS - UNFAVORABLE prognosis

19
Q

MCC of painless testicular enlargement

A

Testicular tumors

20
Q

MC germ cell tumor

4th decade

HISTOLOGY:
LARGE round to polyhedral cells with DISTINCT CELL MEMBRANE, CLEAR or watery appearing CYTOPLASM and CENTRAL NUCLEI w/ 1-2 PROMINENT NUCLEOLI

LYMPHOCYTIC INFILTRATE

A

Seminoma

(+) KIT
(-) cytokeratin

FAVORABLE BEHAVIOR

21
Q

MC testicular germ cell tumor in infants and children up to 3 years

A

Prepubertal Yolk Sac Tumor

22
Q

2nd MC testicular germ cell tumor in infants and children

A

Testicular teratoma

23
Q

2nd MC germ cell tumor in adults

A

Mixed germ cell tumor

24
Q

MC testicular neoplasm in men > 60 years

A

Testicular lymphoma - MC form: DLBCL

25
Q

Peak incidence - 20- to 30-year-old age group

MORE AGGRESSIVE than seminoma

may occur as a pure tumor or mixed with other germ cell components

HEMORRHAGIC MASS

A

EMBRYONAL CARCINOMA

large and anaplastic
hyperchromatic nuclei with prominent nucleoli

LYMPHOVASCULAR INVASION

(-) KIT
(+) cytokeratin, OCT3/4, Podoplanin

26
Q

Also known as endodermal sinus tumor

MC testicular tumor in infants and children up to 3 years of age - very good prognosis

A

YOLK SAC TUMOR

SCHILLER-DUVAL (glomeruloid bodies) - structures resembling
endodermal sinuses

(+) AFP

27
Q

HIGHLY MALIGNANT type of GCT

composed of 2 intimately juxtaposed cell types - syncytiotrophoblasts and cytotrophoblasts

A

CHORIOCARCINOMA

(+) hCG

28
Q

Germ cell tumors composed of elements derived from >1 germ cell layer

2nd MC testicular tumors in infants and children

A

TESTICULAR TERATOMA

AGE - most important predictor of biologic behavior
PREPUBERTAL - BENIGN
POSTPUBERTAL - MALIGNANT

29
Q

2nd MC GCT in ADULTS

A

MIXED GERM CELL TUMOR

30
Q

TUMOR MARKERS

A

LDH - assesses tumor burden

AFP - yolk sac tumor

hCG - syncytiotrophoblasts; choriocarcinoma

31
Q

Sex Cord Stromal Tumors

most cases display a BENIGN behavior

A

Leydig cell tumor
Sertoli cell tumor

32
Q

Associated with:

Klinefelter syndrome
Cryptorchidism
Hereditary leiomyomatosis and RCC syndrome

(+) functional ESTROGENS and ANDROGENS

A

LEYDIC CELL TUMORS

gynecomastia
sexual precocity in children

HISTOLOGY:
Crystalloids of Reinke - 25%

33
Q

Associated with:

Carney complex (caused by germline mutations in the gene PRKAR1A, which encodes a cyclic adenosine monophosphate–dependent
protein kinase)

Peutz-Jeghers syndrome

familial adenomatosis polyposis syndrome

A

SERTOLI CELL TUMORS

testicular swelling

HISTOLOGY:
tumor cells arranged in trabeculae forming cord-like structures and tubules - resemble seminiferous tubules)

34
Q

MC testicular neoplasm in men >60 y/o

AGGRESSIVE tumors

BILATERAL with SPERMATIC CORD
frequent CNS

A

TESTICULAR LYMPHOMA

DLBCL - MC form

35
Q

The most common benign prostatic disease in men older than age
50 years

NOT a premalignant lesion

A

Benign Prostatic Hyperplasia

TRANSITIONAL ZONE

urinary obstruction

enlarged prostate often increases 3- to 5fold (60 to 100 g)

well-defined nodules of BPH compress the urethra into a SLIT LIKE LUMEN

hyperplastic glands with papillary epithelial infoldings

36
Q

Histologic hallmark of BPH

A

NODULARITY

37
Q

MC genetic alteration of Prostatic Adenocarcinoma

A

ETV1-TMPRSS2 rearrangement

38
Q

Risk Factors of Prostatic Adenocarcinoma

A

advancing AGE
ANDROGEN excess
GENETIC - race, family history of prostate cancer in 1st degree relatives, inherited mutations
DIET - charred red meats, animal fat

39
Q

Histologic findings of Prostatic Adenocarcinoma

A

smaller than benign glands, single layer of epithelium (NO OUTER BASAL LAYER), tightly packed cells, usually ROUND (no branching and papillary infoldings)

ENLARGED nuclei + 1 or more large nucleoli

(-) pleomorphism and mitosis

40
Q

Common sites of metastasis of Prostatic ca

obturator – para-aortic nodes

BATSON PLEXUS – BONES (axial skeleton) (BLASTIC lesions)

A

LUMBAR SPINE
proximal femur
pelvis
thoracic spine
ribs

41
Q

Most important prognostic factors in Prostatic ca

A

GRADE AND STAGE

GLEASON SYSTEM

Pathology (24 decks)

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