MALE GENITAL TRACT Flashcards
Testis & Prosate
Most likely primary malignancy to metastasize to this site in males?
Adenocarcinoma prostate
5 complications of cryptorchidism
- Sterility
- Trauma
- Inguinal hernia
- Testicular cancer
- Torsion
A hydrocele can be distinguished from a true testicular mass by which simple clinical exam?
Transillumination
Hydrocele is transillumination positive, true solid testicular mass is transillumination negative
Male, 22 years old, mass in right inguinal canal, empty scrotum on right side. Best surgical treatment?
Orchidectomy
enzyme elevated with bone metastasis of prostate carcinoma
Alkaline phosphatase
4 causes for testicular atrophy
- cryptorchidism
- liver cirrhosis/failure
- Klinefelter Syndrome
- prolonged administration of antiandrogens
1.What’s the diagnosis?
Germ cell tumor
3rd decade
cKIT positive
- Seminoma
1. Diagnosis?
Dragging sensation
Aching pain in scrotum
Visible bag of worms appearance
2. Complication
1. Varicocele
2. Infertility
Nodular Prostatic Hyperplasia/Prostate carcinoma?
Prostatic hyperplasia
Note how well-defined nodules of BPH compress the urethra into a slitlike lumen
Name 1 cause for left sided varicocele
Renal cell carcinoma invading the left renal vein
1. Diagnosis?
20-30 years
testicular mass
variegated, hemorrhage and necrosis
Positive for OCT3/4, CK positive, increased hCG and normal AFP
2. Describe the microscopic pattern
- Embryonal carcinoma
2. Sheets of blue cells trying to form primitive tubules.
Mechanism of this condition
Incompetent venous valves leading to backflow of blood and pooling
Variant of seminoma occuring in the elderly with excellent prognosis?
Spermatocytic seminoma
Prostatic Carcinoma/ Prostatic hyperplasia?
Smal, crowded, well-defined gland patterns lined by a single uniform layer of cuboidal or low columnar epithelium, amphophilic cytoplasm, large nuclei and nucleoli
Prostatic carcinoma
- Most common primary testicular tumor in men >age 60?
- Which particular subtype is it?
- Testicular lymphoma
- non-Hodgkin lymphoma- diffuse large cell type
System used for grading Prostatic cancers
Gleason
most common location for nodular prostatic hyperplasia
Central & Transitional zone
most common location of prostatic carcinomas
peripheral zone
Diagnosis?
- marked hyalinization and thickening of the basement membrane of the spermatic tubules
- Prominent Leydig cells
- increase in interstitial stroma
Cryptorchidism
Cause for Acute epididymitis in age <35
N. gonorrhoeae or C. trachomatis
Germ cell tumor
3rd decade
cKIT positive, CK negative
What’s the gross appearance of this tumor?
homogenous gray white lobulated cut surface, bulky
Carcinoma/ Hyperplasia of prostate?
Adenocarcinoma prostate
Testicular mass - small palpable nodule, hemorrhage, necrosis
Germ cell tumor
Markedly elevated hcG
1. Diagnosis?
2. 2 types of cells seen on microscopy in this tumor
- Choriocarcinoma
- syncytiotrophoblastic cells and
cytotrophoblastic cells
Nodular prostatic hyperplasia/ Prostatic carcinoma
- Proliferation of glands and fibromuscular stroma
- aggregations of small to large to cystically dilated glands lined by two layers of cells, an inner columnar layer and an outer layer of cuboidal or flattened epithelium
- papillary infolding
- corpora amylacea
Nodular prostatic hyperplasia
Most important risk factor for testicular tumors
Cryptorchidism
1. Diagnosis?
Sudden onset of testicular pain, no istory of antecedent trauma, young male
- What’s the mechanism for this condition?
1. Torsion
- Twisting of the spermatic cord—-> impaired venous drainage with patent arteries—–> hemorrhagic infarction.
This twist occurssecondary to a bilateral anatomic defect where the testis has increased mobility
Osteoblastic / osteolytic?
Osteoblastic
Note: osteoblastic= radio opaque
osteolytic= radiolucent
presumptive precursor lesion for prostatic carcinoma
high-grade prostatic intraepithelial neoplasia (PIN)
Name 1 cause for blockade of right spermatic vein
Retroperitoneal fibrosis
Leydig cell tumor belongs to which category of testicular tumors?
Sex cord stromal tumors
Male infant presenting with cryptorchidism before age 1. What’s the best surgical treatment?
Orchiopexy
Tumor marker?
Gross: non encapsulated, homogenous yellow white mucinous mass
Microscopy: reticular network of medium sized flat or cuboidal cells; eosinophilic, hyaline-like globules
Alpha fetoprotein
- Name 1 condition with sudden onset of testicular pain and fever
- Causative infection
- Orchitis
- Mumps
Germ cell tumor
disorganized collection of glands, cartilage, smooth muscle, and immature stroma
Teratoma
dilated veins in the spermatic cord
Varicocele
