Male Genital Reproductive Pathology

Question 1

Cause of Hypospadia

Answer 1

Failure of fusion of urethral folds due to exposure to estrogens/progestins in utero

Question 2

Cause of Epispadia

Answer 2

Rare failure of genital tubercle migration

Question 3

Phimosis

Answer 3

• Prepuce Orifice which prevents normal retraction of foreskin

Question 4

Paraphimosis

Answer 4

• Phimotic prepuce: entrapment of retracted foreskin behind coronal sulcus -> Forced retraction over glands penis
• Causes pain, urethral constriction, + acute urinary retention

Question 5

Balanoposthitis

Answer 5

• Infection of Glans + Prepuce

- Candida; Anaerobes, Pyogenic, Gardnerella

Question 6

Penile Fibromatosis

• Alt name
• Path

Answer 6

• Peyronie’s Disease

- Fibrous thickening btwn corpus cavernosum _ tunica albuginea

Question 7

Condyloma Acuminatum Eti

Answer 7

HPV 6/11

Question 8

HPV HRT vs LRT Path

Answer 8

HRT: Viral genome incorporation

LRT: Episome in cytoplasm

Question 9

Bown Dx

• EPI
• Morph
• alt name

Answer 9

• Carcinoma In Situ
• Men + Women; Shaft of uncircumscribed men
• Morph: Solitary thick gray-white opaque lesions OR Shiny red velvety plaques
• Erythroplasia of Queyrat

Question 10

Bowenoid Papulosis

• EPI
• S/S
• A/S
• Eti

Answer 10

• Sexually active young adults
• pigmented grey/red brown papules
• mistaken for Condyloma Acum
• HPV 16 -> CIS

Question 11

Penile SCC types Histo/morph

Answer 11

Verrucous: Exophytic + well-differntiated

Well-differentiated: Acanthotic, hyperkeratitic; finger-like projectionc

Poorly Differentiated: Nuclear pleomorphism

Question 12

Cryptorchidism

• Types + Controls
• Most common location
• Histology
• Tx

Answer 12

• Transabdominal (MIS); Inguinoscrotal (androgen)
• Undescended testis in inguinal canal
• Hist: Germ Cell Arrest; Thickening of spermatic tubules; INC interstitial stroma; No affect on Leydig Cells
• Tx: Orchioplexy

Question 13

Eti Epidydimitis/Orchitis (5)

Answer 13

• UTI (Gram - Rods; Staph, Pseud. Chlam)
• Auto immune granulomatous Orchitis
• STIs: Gonorrhea + Syphillis
• TB
• Mumps

Question 14

Seminoma

• EPI
• Morph
• Lab
• Spread
• Tx

Answer 14

• EPI: Most common/50%; Never occurs in infants
• Morph: Bulky mass, homogenous gray-white; lobulated; Tunica albuginea
• Lab: (+) PLAP; INC serum HCG
• Spread: Mediastinal + supraclavicular nodes; Hematogenous spread to lungs, liver, brain, + bones
• Tx: Extremely Radiosensitive

Question 15

Leydig Cell Tumor

• Eti
• Epi
• S/S
• Morph
• Histo

Answer 15

• Et: Elaborate Androgens
• EPI: Age 20 - 60
• S/S: Gynecomastia, sexual precocity, testicular swelling
• Morph: homogenous golden brown Circumscribed nodules; 80% benign
• Histo: Large round/polygonal cells’ Rod-shaped crystalloids of Reinke

Question 16

Yolk Sac Tumor

- Histo

Answer 16

• Histo: reticular + endodermal sinus pattern; Schiller-Duvall Bodies (Rounded papillae w/ ding central vessel lined by columnar Cells)

Question 17

Embryonal Carcinoma

• EPI
• Morph

Answer 17

• EPI: aggressive tumor in 20-30 YO

- Morph: Variegated, hemorrhagic, invasive; Large anaplastic Glandular cells