Male Genital Diseases Flashcards
The surface of the penis is made of what tissue?
Squamous epithelium
What are 2 congenital anomalies we studied?
Hypospadias ventral opening (more common)
Epispadias dorsal opening
The scientific name for genital warts is?
Condyloma acuminatum
Which types of HPV most often cause external genital warts?
Type 6, 11, 42, and 44 (HPV is often asymptomatic)
Which types are associated with cervical dysplasia and cervical carcinoma?
16, 18, 31, 33, 35
What types of cells are generated by HPV that can be considered low grade dysplasia?
Koilocytes
What can confer protection from SCC of the penis?
Circumcision
What is the most important type of HPV that leads to SCC?
Type 16
What are other risk factors for SCC of penis?
Smoking and being between 40-70
The prostate is made of?
Fibromuscular stroma with branching glands
What zone of the prostate surrounds the urethra?
Transitional zone
What zone surrounds the ejaculatory ducts?
Central zone
Benign prostatic hypertrophy can be seen in what percentage over men over 40 and 90?
20% and 90% respectively
In what zones does benign prostatic hypertrophy usually occur?
Transitional and central
Is prostate hypertrophy a risk factor for prostate cancer?
No
How is BPH treated?
Drugs to shrink the prostate and transurethral resection of the prostate
How does prostate cancer rank as far as killing men?
2nd most common cause of cancer death
Which race is most prone to prostate cancer? How do hormone levels affect it?
African Americans most likely to get prostate cancer especially if over 50. High testosterone increases risk
How is prostate cancer detected?
- Digital rectal exam
- Prostate specific antigen levels elevated however this doesn’t always mean anything, someone can be normal and have cancer or have high levels and not have it
- If either of these is abnormal perform a transrectal needle biopsy
In what zone of the prostate does cancer usually occur?
The peripheral zone
What is grade 3 primary on the gleason grading system?
Individual round glands that are separate from each other
What is grade 4 primary?
Fused glands with a cribiform pattern
What is grade 5 primary?
No coherent gland architecture
What do you do if it looks mixed?
Add the 2 grades that it looks like however the primary determines how aggressive it is even if two add up to the same number for example 4+3 is more aggressive than 3+4
What is the typical weight of the testis and which is heavier?
15-19 g with the right one being heavier
Prostate cancer typically spread to?
The axial skeleton, pelvis and spine
Where is sperm made?
Seminiferous tubules
Where does sperm mature?
Epididymis
The testes are surrounded by?
Tunica
What is cryptorchidism?
Undescended testis
What is true cryptorchidism?
The testis does not descend down the inguinal canal, gets stuck
What is ectopic cryptorchidism?
Testis forms somewhere other than where its supposed to
Cryptorchidism impairs what process and increases risk for?
Impairs spermatogeneis and increases risk for testicular cancer (seminomas)
How is cryptorchidism treated?
Waiting, most descend on their own. Otherwise, orchipexy
How does the size of an undescended testis compare?
Smaller
Most cases of testicular torsion are due to?
Congenital malformations where the testis is not sufficiently anchored to the inner scrotal wall
Since it is insufficiently anchored, what happens?
Rotates around the spermatic cord causing ischemia
Testicular cancer is seen in what age group? How does it present itself?
18-40, presents as a painless mass. May find abdominal masses in the late stages
What type of testicular tumor is most common?
Germ cell
What are risk factors for germ cell tumors?
Cryptorchidism, p53, and testicular dysgenesis
What is the most common type of germ cell tumor?
Seminoma
When does seminoma usually occur?
In one’s 30’s
Describe the gross appearance of a seminoma?
Gray/white
Solid, well-demarcated. lobulated mass
No hemorrhage or cystic change
How are non-seminomas named?
After what cell they look like
Relatively how many cases of cancer are embryonal carcinomas?
2% are pure but 85% have an embryonal component
What percentage of those with embryonal have metastasis?
65% have it at presentation
Yolk sac tumor is seen more often in whom?
Children under 3, GCT
What is the most common histology in yolk sac tumor? What other feature is present?
Microcystic histology.
Schiller-Duval bodies are seen as well
Choriocarcinoma has what affect on prognosis?
None, but it is often seen in mixed GCT
A choriocarcinoma mimics what structure and what hormone level is raised?
Mimics immature placental villi, increased HCG
What cells are seen in choriocarcinoma that stain for HCG?
Cytotrophoblasts and syncyiotrophoblasts
Teratoma is GCT or NGCT?
GCT, makes up 5%
Teratomas contain elements of what cell layers?
Ecto, meso, and endoderm
How does teratoma present itself in children and what is it associated with?
Presents as pure teratoma, associated with trisomy 21, klinefelter
Teratoma in children is benign, true or false?
True
In adults teratoma is benign or malignant?
Malignant
In adults is it pure or mixed?
Often part of mixed GCT
