Male Clinical Correlations

Question 1

Condyloma Acuminata

Answer 1

significant HPV effect on male genitalia

occur in any moist, mucocutaneous surfaces of male genitals

exposure to HPV virus (especially to types 6 and 11)

results in warty growths

histology:

• papillary (villous) architecture, and thickening of the epidermis
• hyperplastic, hyperkeratonic compared to normal
• koilocytes/koilocytosis = raisin-like nuclei and halo-like cytoplasm among squamous cell epithelium

Question 2

squamous cell carcinoma of penis

Answer 2

looks like squamous cell would anywhere in the body

can be highly well differentiated to undifferentiated

finger-like projections into underlying dermis

lots of inflammatory response

squamous pearls*** - clusters of swirling, keratinizing, fairly well differentiated cells

Question 3

atrophic testes

Answer 3

= undescended (usually)

other causes:

• alcoholism
• hypopituitarism
• atherosclerosis
• chemotherapy
• radiation
• severe prolonged illness

Question 4

germ cell tumor of penis

seminoma

Answer 4

95% of testicular neoplasms are germ cell derived

highly aggressive and metastasize easily

usually respond well to therapy - radiation or chemo

younger males more likely affected (15-34 yrs)

associated with

• undescended testes
• genetic factors
• testicular dysgenesis

Question 5

histology of seminoma

Answer 5

look like serminiferous tubule cells

alot of inflammatory response nesting around…

tumor cells = prominent nucleus, and dark chromatin pattern (benign)

Question 6

leydig cell tumor

Answer 6

Reinke’s crystals associated with leydig cell tumors

if cut tumor = yellow-orange color (excessive testosterone production)

cluster of cells = round nuclei, prominent nucleolus and abundant eosinophilic (lots of capillaries too)

Question 7

benign prostatic hypertrophy (BPH)

Answer 7

redundant because ‘hypertrophy’ = benign

nodules appear mainly in the lateral lobes, compress and narrow urethral canal

associated with DHT levels

prostatic enlargement

patients complain about urinary hesitancy, frequency, nocturia, and dysuria

can result in UTIs

bladder hypertrophy may alos be seen in longstanding cases

Question 8

histology of BPH

Answer 8

compression due to glandular expansion

gland structures still look ‘normal’ prostate glands, there’s a lot more them though

cystic dilated glands seen as well

fibrous like sheet around it = capsule like

Question 9

adenocarcinoma of prostate

Answer 9

tend to be in posterior, peripheral prostate (70%)

higher incidence in african americans…rare in asians

frequent metastasis to bone

histology:

no intervening CT….gland on gland pattern

tumor is close to blood vessel and commonly surrounds nerve swig