Male Genital System Pathology_PATHOMA Flashcards
Testicular SEMINOMA is what ovarian tumor counterpart?
OVARIAN DYSGERMINOMA
Classically ELEVATED AFP = what testicular tumor? ELEVATED beta-HCG?
AFP - classically yolk sac tumor
b-HCG - classically choriocarcinoma
Schiller-Duval Bodies (glomeruloid-like) structures seen in which tumors? (Male and Female)
MALE: Yolk Sac Tumor
FEMALE: Ovarian Tumor
INCREASED AFP testicular tumor Ddx:
CLASSICALLY NON-SEMINOMA: YOLK SAC TUMOR, Maybe EMBRYONAL carcinoma, TERATOMA
INCREASED b-HCG testicular tumor Ddx:
CLASSICALLY NON-SEMINOMA: CHORIOCARCINOMA, Maybe EMBRYONAL carcinoma, TERATOMA
RARELY SEMINOMA
Which testicular tumor has the poorest prognosis due to early hematogenous spread?
NON-SEMINOMA: Embryonal carcinoma has the poorest prognosis
although all non-seminomas generally have a poor prognosis bec of early metastasis relative to seminomas
Which testicular tumor might you also get hyperthyroidism and gynecomastia?
CHORIOCARCINOMA
Bec increased beta-HCG and its alpha subunit that is very similar to FSH/LH/TSH -> Increased activation of
FSH/LH - gynceomastia; TSH - hyperthyroidism
What type of masses do you see with a pt who has choriocarcinoma. Be specific with sizes.
SMALL NODULE on testicle
LARGE Mass elsewhere (lung, liver)
Exception of normal cancer metastases
Name pertinent lab results of CHORIOCARCINOMA.
CLASSICALLY increased beta-HCG,
Possible Increased FSH/LH/TSH due to similarity in structure
What is the most common sex cord tumor? Is it hormonally active or silent? Name the other one.
**most common LEYDIG CELL TUMOR - Hormonally ACTIVE
SERTOLI CELL TUMOR - Hormonally SILENT
Pt presents with testicular mass + enlarged fallices + pubic/axillary hair. What is the most likely diagnosis?
LEYDIG CELL TUMOR - Hormonally active. Increased androgens and estrogens
Which feature is pathognomonic for Leydig cells? If histology shows this feature, can I safely assume that this pt has a LEYDIG CELL TUMOR?
REINKE CRYSTALS
NO - These are present in BOTH normal benign + malignant Leydig cells
Are SEX CORD TESTICULAR TUMORS usually benign or malignant? Are GERM CELL TESTICULAR TUMORS usually benign or malignant?
SCT - usually benign; Leydig cell tumors - hormonally active, Sertoli cell tumors - hormonally silent
GCT - usually malignant
Which is the only testicular GCT that is a PAINFUL testicular mass?
EMBRYONAL CARCINOMA - coincidently has the POOREST PROGNOSIS
What are the two most common bacterial causes of ACUTE PROSTATIS in younger adults?
CHLAMYDIA trachomatis
NEISSERIA GONORRHOEAE
What are the two most common bacterial causes of ACUTE PROSTATIS in older adults?
E.COLI
PSEUDOMONAS
What is the clinical presentation of ACUTE PROSTATIS?
Dysuria + Fever/Chills
How can one confirm ACUTE PROSTATIS on DRE and Culture?
DRE: Prostate is TENDER + BOGGY** (highyield)
Prostatic Secretions - WBC, culture show bacteria
What is the unique feature of CHRONIC PROSTATIS that distinguishes it from ACUTE PROSTATIS?
CHRONIC PROSTATIS - Has pelvic/low back pain + dysuria rather than fever/chill + dysuria
What will PROSATATIC SECRETIONS/CULTURE show on CHRONIC prostatis? which are different than ACUTE prostatis
CHRONIC:
- WBC on prostatic secretions (Same as acute)
- NEGATIVE CULTURE (Diff from acute)
What penile disorder is the opening of the urethra on the INFERIOR surface of the penis? What is the most common embryological cause?
HYPOSPADIAS - Due to failure of urethral folds to close
What penile disorder is the opening of the urethra onto the SUPERIOR surface of the penis? What is the most common embryologic cause of this?
EPISPADIAS - Due to abnormal positioning of the genital tubercle
Which condition is EPISPADIAS associated with?
BLADDER EXSTROPHY - opening of the anterior wall of the abdomen at the lower portion above the bladder -> bladder wall is also not formed properly -> complete exposure of the bladder wall
RAISINOID NUCLEI = what type of histological change? What is the pathologic condition? What viral infections are they most commonly associated with?
KOILOCYTIC CHANGES - Male/Female CONDYLOMA ACUMINATUM
Asssociated with HPV6 or HPV11
What is LYMPHOGRANULOMA VENEREUM?
Necrotizing granulomatous inflammation of the INGUINAL lymphatics + lymph nodes
What is the most common bacterial organism responsible for LYMPHOGRANULOMA VENEREUM?
CHLAMYDIA TRACHOMATIS L1-L3
Does LYMPHOGRANULOMA VENEREUM eventually heal?
YES, with fibrosis
What is a possible complication of LYMPHOGRANULOMA VENEREUM?
RECTAL STRICTURE - if there’s perianal involvement
Which medication is given to a pt with HTN + BPH?
alpha1-antagonist (TERAZOSIN - acts on both alpha1A - prostrate obstruction relief + alpha1B - BV smooth muscle wall)
Which medication is given to a pt who is NORMOTENSIVE + BPH
alpha1A-antagonist (TAMULOSIN - only acts on prostate obstruction relief)
Which medication directly decreases the production of DHT associated with BPH?
5-alpha reductase INHIBITOR (FINASTERIDE)
FINASTERIDE can be administered for which conditions?
BPH + Male pattern baldness
What are the disadvantages of FINASTERIDE in terms of pharmacokinetics + side effects?
Takes months to work + Side effects of gynecomastia + sexual dysfunction
Which PHOSPHODIESTERASE INHIBITOR is the only one that can be used for BPH?
TALADAFIL
What are the 2 risk factors of penile SQUAMOUS CELL CARCINOMA?
HIGH RISK HPV 16/18/31/33
LACK OF CIRCUMCISION
What are the 2 most common bacterial organisms responsible for ORCHITIS in YOUNG, SEXUALLY ACTIVE ADULTS?
Chlamydia trachomatis D-K
Neisseria Gonorrhoeae
What are the 2 most common bacterial organisms responsible for ORCHITIS in older adults?
E.coli
Pseudomonas
Where is inflammation possible due to MUMPS VIRUS?
**Most classically, PAROTID gland
MUMPS - “MOPP”: Meningitis (aseptic) + Orchitis (age >10yo) + Parotitis + Pancreatitis
Ddx of granulomas involving the seminiferous tubules: What is a characteristic of the granuloma that differentiates the two?
Autoimmune orchitis - NON-NECROTIZING GRANULOMA
TB - NECROTIZING GRANULOMA, AFB + Stain
What is TESTICULAR TORSION? What is the most common cause?
Testicular Torsion = Twisting of the spermatic cord
Most common cause: Failure of the base of the testes to attach to the inner lining of the scrotum
What is seen on gross examination and on physical exam to confirm testicular torsion?
- Gross examination - HEMORRHAGIC INFARCT (Incoming blood supply after tissue died + loosely organized tissue)
- PE - Absent Cremaster reflex
What is the most common association of left spermatic vein varicocele (Dilation due to impaired drainage)?
LEFT RENAL CELL CARCINOMA
