Male Genital system Flashcards
What is the ventral side of the penis
bottom
what is the dorsal side of the penis
top
what is hypospadias
abnormal opening of the urethra along ventral aspect of penis
What is epispadias
abnormal opening of urethra along dorsal aspect of penis
hypospaidas and epispadias are associated with what abnormalities
malformation of urethral groove and canal
un-descended testis
GU malformation
micropenis
abnormally short shaft
diphallus
two penis
bifid scrotum
2 scrotal sacs
phimosis
orifice of prepuce is too small to permit retraction
how does one get phimosis
congenital or
acquired by inflammation
phimosis is predisposed to what
infection
carcinoma
Balanoposthitis
infection of glans and prepuce
- nonspecific infection from bacteria/fungus
- not sexually transmitted
What does herpes look like
superficial ulcer
HSV-2 main
what does syphilis look like
T. pallidum
chancre slightly raised
red papule
shallow ulcer
Name 4 dermatological penile lesions
- pemphigus
- lichen planus
- fournier’s gengrene
- peyronie’s disease
What is phemphigus? What causes it?
- blistering disease caused by autoantibodies
- suprabasal acantholytic blister
what is lichen planus
flat topped pink purple papule self limited
- etiology not known
Fournier’s gengrene
subcutaneous infection with gas production, necrosis
- can spread to other ares
What is Peyronie’s disease
- circumscribed fibrous thickening of connective tissue
- hyalinized
- may have cartilage and bone
- painful curvature of penis toward lesion
Peyronie’s disease is associated to what
chronic urethritis
Name 2 neoplastic disease
Condyloma Acuminatum
Giant Condyloma
Condyloma Acuminatum is associated with what disease
HPV
what is Condyloma Acuminatum
- sessile or pedunculated
- variable size
- acanthosis
- hyperkeratosis
What is acanthosis
thickening of epidermis
what is hyperkeratosis
thickening of keratin layer
another name for Giant Condyloma
Buschke–Löwenstein tumor
What does Giant Condyloma look like
large cauliflower like
multiple
What is the differential diagnosis for Buschke–Löwenstein tumor
verrucous carcinoma
who usually gets Giant Condyloma
older individuals
what is the histology for Condyloma Acuminatum
papilloma –> finger like projections
Koilocytosis
what is Koilocytosis
HPV cytopathy, perinuclear clearing
Name 3 dysplastic/CIS lesions of penis
Erythroplasia or Queyrat
Bowen’s Disease
Bowenoid papulosis
dysplastic/CIS lesions of penis are usually caused by what? and how are they all similar
HPV 16
all squamous cell carcinoma in-situ
What is Bowen’s disease
lesion on skin of shaft
plaque like
Where does Erythroplasia of Queyrat occur
lesion on glans
how are Erythroplasia of Queyrat and Bowen’s disease similar? different?
similar: same histo
different: Q- no increase in visceral Ca
B: increase probability of visceral cancer
Who gets Bowenoid papulosis
young sexually active adults
What are the low risk HPV
6, 11
What are the high risk HPV
16,18,31
What is similar about Bowenoid papulosis with Bowen’s disease and Erythroplasia of Queyrat? difference?
same histo
- Bowenoid papulosis has rare malignant transformation
What does Erythroplasia of Queyrat look like
soft, red, ulcerated plaque
- dermal inflammation
what is histo for erythroplasia of Queyrat
- irregular dysplastic acanthosis
- diminished keratin layer
What does Bowen’s disease look like
bright red plaque with moist surface
How many lesions and who usually gets Bowen’s disease
single lesion
older patient
What is the histo for Bowen’s disease
- dysplastic and anaplastic cells in epithelial layer
- intact basement membrane
What does bowenoid papulosis look like? how many?
multiple pigmented papules
squamous cell carcinoma usually occurs in who
older populations
what protects males from squamous cell carcinoma
circumcision
what lines the normal testis
tunica vaginalis
what is cryptorchid testis
undescended testis
- in inguinal canal or abdomen
Cryptorchid testis increases risk for what
- bilateral: infertility
- germ cell neoplasms
what is histo and groos for cryptorchid testis
- increased hyaline deposition
- failure of germ cell maturation
- increase or normal Leydig cells
- tubular atrophy
atrophy of testis causes what
- interstitial scarring
- tubular basement membrane thickening
- loss of spermatogenesis
- fibrosis
- decreased or absent germ cells
Gonorrhea is seen where and what does it look like
- epididymis
- abscess formation and general inflammatory changes
how does mumps impact the male reproductive system
- heavy mononuclear inflammation
- edema
- may have neutrophils and abscesses
who usually gets mumps
- adolescent and adults
Where does syphilis impact first and then spread where
- testis
- spread to epididymis
what does syphilis look like
- gummas or diffuse inflammation of lymphocytes
- plasma cells
- obliterative endarteritis
- perivascular cuffing
Where does tuberculosis start and spread to
start epididymis then to testis
what does tuberculosis look like
classic caseating granulomas of TB
What is torsion? what problems does it cause
twisting of spermatic cord and blockage of venous drainage
- hemorrhagic infarction of testis
- acute testicular pain and swelling
is torsion a medical emergency
yes
Benign paratesticular tumor: adenomatoid tumor usually arises from where
epididymis, mesothelial in nature
are tumor markers present in adenomatoid tumor
no
histo for adenomatoid tumor
cuboidal/flat cells in cords
cytoplasmic vacoule
Intratubular germ cell neoplasia is associated with what
isochromosome 12p
testicular tumors usually occur in who
young people
how do testicular tumors present
painless testicular mass
germ cell tumors are associated with what
testicular dysgenesis syndrome
what is clinical features of testicular dysgenesis syndrome
- cryptorchidism
- hypospadias
- poor sperm quality
testicular tumors express what genetically
OCT3/4
NANOG
25% of seminomas have what activating mutations
KIT
What are 2 germ cell tumors
AFP
HCG
when do you see AFP
yolk sac tumors
when do you see HCG
- choriocarcinoma
what age group usually gets seminoma
30s
name 3 serum markers for seminoma
hCG (10%)
AFP negative
PLAP
histo for seminoma
- lobules with think septa
- large cells
- prominant nucleoli
- sparse lymphocytes
who usually gets Spermatocytic seminoma
over 65
old
what are 3 types of cells in spermatocytic seminoma
- small cells
- intermediate cells
- large cells
what is the marker for embryonal carcinoma
PLAP positive
marker for yolk sac tumor
positive for AFP ( alpha fetoprotein)
serium elevations for monitering
yolk sac tumor name microscopic patterns
endodermal sinus pattern
schiller-Duvall bodies
Choriocarcinoma mets where
liver/lung
Choriocarcinoma impact what 2 cells
- syncytiotrophoblastic cells ( large cell with irregular nuclei)
- Cytotrophoblastic cells ( smaller regular cells with clear cytoplasm)
Germ cell testicular tumor biopsy associated with
tumor spilllage
what are the clinical stages of germ cell testicular tumors
stage 1: confined to testis, epididymis or spermatic cord
stage 2: retroperitoneal nodes below diaphragm
stage 3: mets
these markers go with what disease
LDH
AFP
HCG
LDH - tumor burdern/volume
AFP - yolk sac tumor
HCG- choriocarcioma
histo for sertoli cell tumor
distinctive trabeculae with cordlike structures and tubules
