Male and Female Tract Pathology (6) Flashcards
What is Cryptorchidism
incomplete testicular descent at 1 that can be unilateral or bilateral
what are the types of cryptorchidism
true (it follows the inguinal canal but doesn’t descend completely)
ectopic (it doesn’t follow the inguinal canal and can end up somewhere else)
What are the problems with cryptorchidism
its associated with sterility and malignancy
how is cryptorchidism treated
orchiopexy - moving the testicle into the right location via surgery
What is the most common type of cancer in men 15-35
testicular cancer
What is looked for when doing a self evaluation for testicular cancer
enlarged testicle with a distinct lump
feeling of heaviness in the testicle or groin
changes in the way the testicle feels
What are the two main groups of testicular cancer
seminomas and nonseminomas
What are seminomas
tumors that arise from germinal epithelium of seminiferous tubules.
they often remain localized and don’t metastisize early. they are very sensitive to radiation and chemotherapy
What are the four types of nonseminomas
embryonal carcinoma
yolk sac tumor
choriocarcinoma
teratoma
What is an embryonal carcinoma
a tumor of undifferentiated stem cells, poorly differentiated and pleiomorphic.
there are usually no tumor markers
What is a yolk sac tumor
a tumor of yolk sac cells that occurs around 3 years
there are glomerulus like structures (Schiller-duval bodies)
90% of patients have an elevated alpha fetoprotein
What is a choriocarcinoma
a tumor of trophoblastic cells.
all patients have elevated hCG
What is a teratoma
a tumor of somatic tissue cells
the tissues are random (neural, muscle, brain, etc.)
no tumor markers
How is treatment of testicular cancer
with early detection there is a 90% cure rate
seminomas metastisize less, and are more sensitive to chemo and radiation
non seminomas metastisize earlier and farther and have a worse prognosis
What is torsion of the testis
rotation of the testi which causes blood vessels and the spermatic cord to twist. Its painful and causes the testis to swell. it can happen all on its own or due to strenuous activity
What are the three disorders of the scrotum
varicocele - inflammation/dilation of veins (valve problem)
hydrocele - scrotal swelling, fluid in the tunica vaginalis
spematocele - dilation of the epididymis
What is orchitis
acute inflammation of the testis
What is epididymitus
painful inflammation of the epididymis that is common among sexually active young men. an infection from the bladder or urethra travels to the epididymis.
What are the two types of prostate cancer
nodular hyperplasia and carcinoma
What is nodular hyperplasia of the prostate
benign proliferation of the glands and stroma
due to excessive androgen stimulation.
symptom is urinary obstruction due to compression of urethra
What are the stages and symptoms of prostate carcinoma
early = no symptoms (PSA exam detection)
late = hard nodule felt in rectal exam
very late = local pain and obstuctive syndromes
What is a PSA exam
PSA is an enzyme made in the prostate
PSA 10 suggests cancer
But it isn’t terribly reliable
What things influence likelyhood of prostate carcinoma
hormones, genetics, environment
how do we know hormones influence prostate carcinoma
castrated males before puberty don’t get it
orchiectomy and estrogen treatment works
how do we know genes influence prostate carcinoma
there is an increased risk in first-degree relatives
there is an earlier onset in African American
How do we know that the environment influences prostate carcinoma
there is an increase in scandinavian countries, and a decrease in asian countries
how does it appear that diet affects prostate carinoma
hyperinsulinemia is associated with accelerated growth of prostate cancer
How is prostate carcinoma treated
surgery, radiation, and hormone therapy
what is phimosis
foreskin is too tight to retract
what is paraphimosis
foreskin is too tight to go over the glans
What causes phimosis and paraphimosis
poor hygiene or chronic infections
What is peyronie Syndrome
“bent nail syndrome” which is excessive curvature of the penis during erection. it is painful and caused by the development of fibrous plaques in the corpus cavernosa
What is the precursor to cervical carcinoma
cervical intraepithelial neoplasia (CIN)
almost all cases of cervical carcinoma arise from CIN, but not all CIN leads to cervical carcinoma
What are the different grades of Cervical intraepithelial neoplasia (CIN)
I , II, and III (I and II are low grade, III is high grade)
the higher the grade, the more likely it is to progress to carcinoma
What are the risk factors for developing cervical carcinoma
early age at first intercourse multiple sexual parteners persistent HPV infection Smoking Immunodeficiency
How is HPV and cervical cancer correlated
HPV is detectable in almost all CIN and cancer
High risk HPV is found in carcinomas
Low rist HPV is found in condylomas
From what do most cervical carcinomas arise
most cases are squamous arising from CIN,some are adenocarcinomas
What is endometriosis
endometrial tissue located outside the uterus, often in peritoneum (rarely in lymph nodes)
The endometrial tissue stil undergoes cyclic bleeding and causes scarring, pain and sometimes sterility
What causes a chocolate cyst in the ovaries
endometriosis
What is endometrial hyperplasia
the proliferation of endometrium due to excess estrogen that can cause anovulatory cycles, obesity, estrogen producing ovarian tumors, exogenous hormone use
What are the three types of endometrial hyperplasia, and which is most likely to develop into carcinoma
simple, complex, and atypical
this is the order of least to most likely to develop into carcinoma
What is leiomyoma
a fibroid benign tumor of smooth muscle that is pretty common and is stimulated by estrogen.
what are the symptoms of leiomyoma
menorrhagia
metrorrhagia
asymptomatic
What is leiomyosarcoma
a malignant tumor of smooth muscle with necrosis, atypical cells and lots of mitoses. many of these metastisize
What is endometrial cancer
cancer of the endometrium that usually arises from endometrial hyperplasia.
What are the risk factors for endometrial cancer
obesity, nulliparity, estrogen replacement
What are the symptoms of endometrial cancer
leukorrhea, irregular bleeding
What are the different classifications of ovarian tumors
surface epithelial tumors
germ cell tumors
sex cord-stromal tumors
what are the three different surface epithelial tumor types
serous (60% benign, p53 mutation)
mucinous (80% benign, proliferation of mucus secreting cells)
cystadenofibroma (benign tumor of surface epithelium, Large, cysts then neoplasm)
What are the symptoms of ovarian tumors
feeling full or bloated
pelvic pain
back pain
abnormal menses
What are the risk factors for ovarian tumors
nulliparity
family history
not using oral contraceptives
what is the prognosis for ovarian tumors
when confined to the ovary, 5y = 70%
when through the ovarian capsule, 5y = 13%
What is Polycystic ovarian syndrome (PCOS)
multiple cystic follicles that secrete excess androgens
What are the symptoms of PCOS
Hirsutism
oligoovulation (infrequent) or anovulation
Hyperadrogenism
Infertility
What effects does insulin have on the ovaries (premenopause)
it causes Testosterone production in the ovaries
and it inhibits aromatase, which converts Testosterone to Estradiol. so a low CHO diet helps with PCOS
What effect does insulin have (postmenopause) on adipose
it increases Testosterone production in adipose
What effect does insulin have on the testis
decreases testosterone production in testis
What is a breast mouse
fibroadenoma, the most common benign breast tumor. it is stimulated by estrogens and is discrete and movable
What are the risk factors for breast carcinoma
age (75% of patients are older than 50) familiy history increased estrogen exposure alcohol obesity high-sugar diet
how do CHO influence breast cancer risk
CHOs increase risk of breast cancer (tumors can have more insulin receptors)
What are the non-invasive carcinomas
Ductal carcinoma in situ (DCIS)
Lobular carcinoma in situ (LCIS)
What are the invasive carcinomas
ductal (most common)
lobular
inflammatory ( peau d’orange, inflamed breast)
How is a prognosis for breast carcinoma determined
size of tumor lymph node involvement distant metastises grade of tumor histological type
What is gynecomastia
overdevelopped breast tissue in males
what can cause gynecomastia
hormone alterations
hypogonadism
obesity
