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Repro > Male Genital Pathology > Flashcards

Male Genital Pathology Flashcards

1
Q

Most common penile congenital abnormalities?

A

Epispadias and hypospadias

abn openings of urethra on dorsal or ventral penis; due to malformation of urethral canal

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2
Q

What is the clinical importance of a urethral abnormality?

A

urethral obstruction or failure of normal ejaculatory function

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3
Q

Inflammation of the penis is most commonly related to:

A
  • -phimosis (inability to easily retract the foreskin)

- -venereal disease

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4
Q

Inflammatory condition most commonly related to poor hygiene:

A

balanoposthitis

glans inflammation = balanitis; foreskin inflammation = posthitis

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5
Q

Neoplasm that occurs almost exclusively in the uncircumcised:

A

Squamous carcinoma of the penis

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6
Q

What are condyloma acuminata?

A

cauliflower like growths which occur primarily in the anogenital region; recurrent despite vigorous therapy

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7
Q

What causes condyloma acuminata, and how it it transmitted?

A

HPV 6 or 11

sexually

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8
Q

Hisopath of condyloma acuminata?

A

Orderly, exuberant exophytic (growing outward) growth pattern of papillary lesion

very few mitoses

no necrosis

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9
Q

Squamous carcinoma in situ on the penile skin is called:

A

Bowen disease

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10
Q

Squamous carcinoma in situ on the glans is called :

A

erythroplasia of Queyrat

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11
Q

What causes squamous carcinoma in situ of the penis/glans?

A

HPV, usually type 16 (80%)

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12
Q

Why should you treat squamous carcinoma in situ of the penis/glans?

A

if untreated roughly 10% will progress to squamous carcinoma

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13
Q

What is the clinical manifestation of squamous carcinoma in situ of the penis/glans?

A

red, slightly raised, rough, painless, nonulcerated lesions

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14
Q

Histopath of squamous carcinoma in situ of the penis/glans?

A

hyperkeratosis with disordered maturation + elongation of rete ridges

thickening of epidermis

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15
Q

50% of the time, squamous carcinoma of the penis is caused by:

A

HPV (usually 16 and 18)

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16
Q

Lifestyle risk factors for squamous carcinoma of the penis?

A

poor hygiene and cigarette smoking

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17
Q

What is Cryptorchidism?

A

Failure of descent of testis from abdomen to scrotum, present in 1% of 1yr old boys

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18
Q

If a failure occurs during the Transabdominal phase, where are testes stuck?

A

between abd and brim of pelvis

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19
Q

What signaling molecule is important during the Transabdominal phase?

A

Mullerian inhibiting substance

20
Q

If a failure occurs during the Inguinoscrotal phase, where are testes stuck?

A

between brim of pelvis and scrotum

21
Q

What signaling molecule is important during the Inguinoscrotal phase?

A

Androgen-induced calcitonin-gene related peptide

22
Q

During what phase of testes droppin’ do abnormalities more commonly occur?

A

Inguinoscrotal (90-95% of cases)

23
Q

Complications associated with Cryptorchidism:

A
  1. increased susceptibility to trauma, if Inguinal
  2. Sterility
  3. Decreased spermatogenesis in BOTH testes in unilateral cryptorchidism
  4. Malignant neoplasms (5-10 fold increased risk; some increased risk in normal testis, too)
24
Q

What improves (but does not guarantee) chances of normal spermatogenesis in Cryptorchidism?

A

Orchiopexy before age 2

25
Q

What reduces (not eliminates) cancer risk in Cryptorchidism?

A

orchiopexy

26
Q

What histopath is associated with Kleinfelter’s?

A

Small hyalinized seminiferous tubules

Pseudoadenomatous clusters of Leydig cells (only look increased in # due to decreased testicular volume)

27
Q

What conditions are associated with Kleinfelter’s (increased incidence)?

A

extragonadal germ cell tumors (mediastinum > pineal gland, CNS, retroperitoneum)

hypopituitarism

28
Q

What reproductive abn are associated with Kleinfelter’s?

A
  1. small to normal-sized, well developed testes (**the picture above it says they’re less dev)
  2. Incomplete virilization (infertility)
  3. gynecomastia
29
Q

How does tertiary syphilis spread?

A

testis first, then the epididymis

30
Q

How does gonorrhea spread?

A

retrograde from the urethra to the prostate, seminal vesicles, epididymis

31
Q

What is the most common infectious cause of focal atrophy of the testicular tubules?
What are some other causes?

A

mumps orchitis

echovirus, lymphocytic choriomeningitis virus, influenza virus, Coxsackie virus, and arboviruse

32
Q

How does mumps affect testicular tubules?

A

unilateral and patchy orchitis (thus, sterility uncommon)

33
Q

What are the symptoms of epididymitis?

A

scrotal pain and swelling

34
Q

What are common causes of epididymitis in younger males?

A

sexually transmissible diseases:
Chlamydia trachomatis
Neisseria gonorrheae

(can also be disseminated TB)

35
Q

What are common causes of epididymitis in older males?

A

gram negative bacteria from UTI

can also be disseminated TB

36
Q

Idiopathic granulomatous orchitis is an uncommon diffuse inflammatory testicular lesion that occurs following:

A

gram negative urinary tract infection (usually)

37
Q

Idiopathic granulomatous orchitis occurs in what age group?

A

50-60 y/o men

most commonly

38
Q

What is a differential dx for Idiopathic granulomatous orchitis, and why?

A

testicular neoplasm

may present as a localized nodular lesion

39
Q

What parts may be involved in Idiopathic granulomatous orchitis?

A

testicles, epididymis and spermatic cord

40
Q

Histopath of Idiopathic granulomatous orchitis?

A

predominantly intratubular inflammation

cellular infiltrate containing histiocytes (majority), lymphocytes, plasma cells, +/- giant cells

Note: histiocytes give appearance of granulomas, but they aren’t actually present

41
Q

Is necrosis present in granulomatous orchitis?

A

NO!

42
Q

How is granulomatous orchitis distinguished from infectious orchitis or sarcoid?

A

intratubular localization of inflammation in granulomatous orchitis

43
Q

What is autoimmune orchitis?

A

rapid onset granulomatous testicular enlargement in middle aged men (may be associated with a febrile illness)

44
Q

What are the causes of testicular regression/atrophy (in general, and according to his mnemonic)?

A

Vascular (varicoceles = atrophy on side of dilated veins)

Inflammation (mumps orchitis, epidydimoorchitis)

Neoplasms (atrophy occurs in estrogen trx of prostatic carcinoma)

Degenerative (atrophy resulting from aging)

Intoxication (chronic alcoholism, Laennec cirrhosis, hemochromatosis, X-ray)

Congenital (undescended testes and torsion)

Trauma (atrophy following vasectomy and accidental ligation of the blood supply during hernia repair)

Endocrine (hypopituitarism, Klinefelter and other eunuchoidal states)

VINDICaTE

45
Q

What can occur in the testes following torsion?

A

ischemia + venous stasis

46
Q

Why is torsion a urologic emergency?

A

surgery within 4-6 hours may save the testis

if not, hemorrhagic infarction with obliteration of the testis is inevitable

Repro (27 decks)

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