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1
Q

acute cystitis /urocysttitis

A

-frequent urination, low abd pain, dysuria, pollakiruia
-female
-ecoli, prtoeus, abicans
-ascending, descending, prorgenous!!!

risk: IMMUNODEFICIECNY, Chemo, RADIO

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2
Q

chronic cysttis

A

-irregualrity of mucosa, redness, fatigue, ulcerated, fraginle
-chronic infiltarte, fibrosis of muscularis propria

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3
Q

cysttis cystica

A

haracterized microscopically by Brunn’s nests growing into the lamina propria, transformed into cleft-shaped or cystic spaces

long lasting chronic cystitis, ureteral reimplantation, neurogenic bladder or other causes of chronic mucosal irritation

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4
Q

cystic gkandularis

A

Metaplastic change into glandular epithelium —> Usual type and intestinal metaplasia (goblet cells, mucinous columanr epithelum)

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5
Q

neoplasm of Urinary bladder

A

epithelia-most common
-benign: uretelial/ttansitional papilloma, inverted papilloma
-premalignant changes: dysplasia
-malignant: noninvasive, invasive

mesenchymal
-bening: leiomyoma, haemangioa,, neurofibroma
-malignant: thabdomyoSa(sarcoma bothryoides), fibroSa, LeiomyoSa

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6
Q

classificaiton of urotheila neiplasm of UB

A
  1. flat lesions w atypia
  2. papillary (non invasive )urothelial neoplasia
  3. invasive urothelial neoplasi
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7
Q

flat lesion w atyoia of UB

A

-racticva and UA of unkown significanse

LG urothelial dyplasia-LG IUN

HG……:=======CARCINOMA IN SITUUUUUUU—->ICU

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8
Q

papillary urotehlial neoplasia

A

-papilloma and inverted papilloma

PUN-LMP: low malignnt
non invasive low/high

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9
Q

Invasive urothelial neoplasia

A

invasive uro carcinoma-IUC’: HTORUGH BM TO SUBMUCOSAL/LAMINA PROPRIA

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10
Q

uretohelial neoplasm of UB most common

A

Pappilary type more-80%
pst and lat wall70%

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11
Q

papilloma of UB

A

-rare, benign, small and isloted
-younger
-HAEMATURIA

macro:
-sfot, pink, papillaru structure, pedunculated

micro:
-satlk w central fibrovascular core, urothelium of normal thickness

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12
Q

urothelila carcinoma of UB

A

-90% of ub acner
-any apart-mostly multifocal

75-85% is non invasiv!!!!
papilalry growth
>50y, smokinf, arylamines , aromatic and polycylcic carbs, parasites

symptoms: PAINLESS HAEMATURIA, RARLY PAIN,

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13
Q

urothelila Cis

A

-no papp aka flat lesion
-epi cell cytological malignant

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14
Q

inasive yrothelial carcinoma clinical and prognostic factors

A

clinical
- painless, haemturoa, infection, obstruction of uretral orficies
-70% locakued to bladder
-MTS–>LN, lung, liver, bone, cns

prognostic factors
-STAGING
-infiltartive inavsive : nodular or trabecular
-hig low grade
-younger=low grade and non invasive

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15
Q

bening prostatic hyperplasia

A

-central(peri urethral) zone
-affect 70% of men aged 60y
-typical feature: urianry incontinece and UTI
-Prostate hyperplasia is characterized by the formation of nodules of various sizes
-Prostate hyperplasia is a non-neoplastic tumor similar to prostate enlargement

Non-cancerous enlargement of the prostate gland.
Happens in older men (very common after 50 years).

Caused by hormonal changes (↑ DHT = dihydrotestosterone).
Enlarged prostate compresses urethra → urinary problems:
Weak stream, urgency, frequency, nocturia (night urination).

Complications: urinary retention, bladder infections, kidney problem

periurethral nodules compress urethra – obstruction, recurrent urinary tract
infections, urinary retention, bladder hypertrophy

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16
Q

premalignt cahges: prostic intraepi neoplasia (PIN)

A

-neoplastic transformaiton of epi of prostatic acini and ducts
-atypia cytological
-low and high (–>prostatic CA)

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17
Q

prostatic carcinoma

A

-90% over >55y have it

etio: androgens snesitivt
-not smoking , STD or nodular hyperplasia
-non agressive, slow growing

clinical
1. asymp for lomg time-PAS Eelevated
2.
a. local extesnive: low urinry tract symp, pelvic pain, hematuria, rectal bleeding, obstrcuiton
b. metatstatic prostatic adenocarcinoma
-bone pain-pelvic and axial, pathological fractures, effusions

where:
70% in pripheral zone
-periurethral later
-gritty an firm, yellow grey, poorly defined
-

90%=ACINARY ACa
small growded glands, enlarger hyperpchromatic nuceli, prominent nucleoli

PNI-peinerual prpagatom

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18
Q

prostic carcinoma prognostic factors: ctaegories

A
  1. PSA, Gleason score, TNM stage, surgical margin
  2. tumor volume, hsitological, dna ploidity
  3. PNI, ne diff, microvv densitym enucelr, genes,…
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19
Q

gleason score

A

patterns:
1-3: retained epi polarity in luminal differentiation
4: partial loss of poalry
5: totoal loss

gleason score
GS=1(pri, dominant)+ 2(sec) gelaosn pattern
-form 2-10
-if only one pattern->x2 of same

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20
Q

progression+mst of PC

A

-invasion into seminal vesicle or to UB
-into prostaic urethra
-into recatl storma

MTS:
-skelet-osteoblastic MTS(axial)
- MTS->lung, pleura, liver, adrenald gland, LN

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21
Q

cryptorchidism

A

def: absence of at least one testicle from the scrotum

-testis msot often locaeted in inguinal canal
-INIDCATED in orchidopexy
-testes are mor eprone to torsion
. is permanent retention of testis outside scrotum

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22
Q

urinary colic is a manifestaiton

A

urinary calculi=kidney stone

23
Q

prostatism

A

Prostatism isa syndrome associated with outlet obstruction at the bladder neckand the commonest cause is benign prostatic hypertrophy. The main indications for investigation and treatment are these symptoms (especially nocturia). - NIH

24
Q

manifestion of hydronephrosis

A

nocturia and polyuria

25
Common finding in nodular prostatic hyperplasia
Corpora amylacea in the prostate
26
urocystttis
infla of UB
27
High-grade noninvasive papillary urothelial Ca
macro: -sessile or cauliflower-like with necrosis and ulceration micro: prominent architectural and cytologic abnormalities, solid, nodular, papillary or flat, more nuclear pleomorphism/anaplasia than low grade, prominent nucleoli, irregularly clustered cells, disorganized epithelium, mitotic figures at all levels
28
infla of prostate types routes
non specific -acute bacterial prostatitis, abscess of prostate -chronic bacterial/abacterial prostatitis granulomatous prostatitis specific -TBC prostatitis -after BCG vaccine route -ascending, descending, catethrisation(staph, strep, gonoccous, myco)
29
orchiprcy
placemnt of testis in scrotal sac
30
atrophy of testis
-parotitis, orchitis, cryptochidism, hypopituitarismus, semen ouflow obstruction, radiation, chemo, femal hormones, cirrhosis, klinefelter syndrome
31
torsion of testis
-spermatic cord twist -painful -result: ischmie/necrosis
32
orchitis
-acute or chronic(tert syphilis, YBC) -assocoated with epidydimitis -viral eto -grnaulomatous chtiis -testis enlargemnt, pain , later:atrophy and infertitlt
33
testicular neoplasm
- 95% are GCT (aggressive, but curative) - 5% are SCST(usually benign, but associated with hormonal syndromes) may be mixed (GCT+SCST) -GCT should not arise only in testis (not specific to testis) - lymphatic spread to periaortic, iliac, mediastinal and supraclavicular LN - haematogenous spread to liver, lungs, brain, bones
34
germinal cell tumros
-from totipotent germinal cells -15-34y - 60% mixedddd classifixiotn 1. seminomatous: radiosens, 40y 2. nonseminomatous: resistnt, 25y predisposing factos -cryptochidism, testilcualr dysgeneis, klienfelts, li fraumenis yndomre
35
seminoma
-rare in childne -mediastinum pr retroperitoneum also -^placentar alcalic phosphatase-PLAP -MTS to LN , bones, heamothensi
36
no seminomatous
more aggressive than seminoma - early haematogenous MTS spread MTS should not have morphology of primary tumour - radioresistant - 80% have increased serum level of αFP or hCG Prognosis: 95% are curable, if absent MTS in LN and distant MTS 40-95% is curable when MTS are present - bad prognosis when extensive MTS in lung
37
embryonal Ca(ECa
-20-30y - most MTS -often asym-back pain, dyspnoe, neurologic syndorme
38
yolk sac tumor-YST
-endodermal sinus tumour 'most common testicular tumor in age 3 or less, often pure, good prognosis at this age - in adults usually part of a mixed tumor, prognosis as ECa - 95% of patients with tumors containing YST elements have elevated serum αFP - tumours are usually aneuploid Schiller-Duval bodies are a characteristic histological feature of testicular yolk sac tumors.!!!!!!!!!!!!!!
39
teratoma
-5% of GCt -large, multinodular, heterogenosu Classification: a.) mature teratoma b.) immature teratoma c.) teratoma with malignant transformation d.) dermoid cysts (rare in men)
40
mature teratomas
diff cells or organoid structure including cartilage, nerveim
41
immature
-foci resembling embryonic or fetal structure
42
teratomas with malignnat transformaiton
focal malignancy of somatic tyoe (SCC, adenoCA, Sa)
43
dermoid cyst
rare, may represent direct transformation from a nonmalignant germ cell, appear to be benign even in adults, resemble ovarian dermoid cysts
44
Choriocarcinoma (ChCa)
-malignant neoplasm composed of syncytiotrophoblastic (STB), cytotrophoblastic (CTB) and intermediate trophoblastic cells -may be presented initially with MTS (liver, lung, mediastinum, retroperitoneum) with normal testis or small tumour, but with increased serum hCG - early haematogenous spread to lungs, liver and brain
45
mixed GCT
- includes GCT composed of two or more types frequency of mixed germ cell tumours has been reported between 32-54% of all GCT EC+TER = (teratocarcinoma) 47% EC+YST = 41%
46
sex cord/gonadal stormal tumors-SCST
neoplasms containing epithelial elements of sex cord origin (Sertoli and granulosa cells) admixed with elements of mesenchymal origin (Leydig and theca-lutein cells) in varying combinations and degrees of differentiation 5% of adult testicular tumours and over 30% tumours in infants and children about 10% of these tumours metastasize production of hormones Thecoma / Fibroma Granulosa cell tumour (adult, juvenile) Leydig (interstitial) cell tumor Sertoli cell tumors (androblastoma)
47
Mixed (combined) GCT + SCST
Gonadoblastoma rare neoplasms composed of a mixture of germ cell and immature sex cord / gonadal stromal elements (including Sertoli and Leydig cells) - all arise in dysgenetic gonads
48
phimosis
It is a condition in which the foreskin of the penis is too small to allow it to normal withdrawal behind the acorn of the penis
49
paraphimosis
It is a condition in which the fibrous foreskin of the penis is forcibly retracted behind the glans of the penis and is not it can be retracted back
50
hypospadias
There is a developmental defect of the urethra in which the urethral canal does not reach the end of the penis, but instead it opens to the front of the penis
51
epispadias
There is a developmental defect of the urethra in which the urethral canal does not reach the end of the penis, but instead it opens to the back of the penis
52
The following lesions of the penis are not carcinoma in situ:
- Bowenoid papulosi - Queyrat erythroplasia - Bowen's disease this one: - Condyloma acuminatum
53

PATHOANA 2 (14 decks)

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