Male Genitourinary Pathology

Question 1

Describe the normal histology of the prostate.

Answer 1

Glands lined by 2 layers of cells, epithelial and basal, and glands surrounded by fibromuscular stroma.

Question 2

List some non-neoplastic lesions of the prostate.

Answer 2

Infection: acute or chronic bacterial prostatitis, tuberculous prostatitis.
Inflammation: non-specific chronic prostatitis, granulomatous prostatitis secondary to BCG treatment, xanthogranulomatous prostatitis.
Depositis: calculi, amyloid.

Question 3

Briefly describe histological features of non-neoplastic chronic prostatitis.

Answer 3

Numerous small dark blue lymphocytes seen in the stroma between the glands, but glands appear normal.

Question 4

List some neoplastic lesions of the prostate, both benign and malignant.

Answer 4

Benign: leiomyoma, benign prostatic hyperplasia.
Malignant: adenocarcinoma, leiomyosarcoma, stromal sarcoma, secondary malignancy.

Question 5

Briefly describe the histological features of benign prostatic hyperplasia.

Answer 5

Hyperplasia of both the glands and the stroma, with glands still lined by 2 cell layers (epithelial and basal). Glands also appear bland.

Question 6

Briefly describe the histological features of prostatic adenocarcinoma.

Answer 6

Cells have prominent nucleoi, there is complete absence of basal cells, the glands appear back to back, are a single layer.

Question 7

List some non-neoplastic lesions of the penis.

Answer 7

Congential: short prepuce that cannot be contracted over corona.
Inflammation/infection: warty lesions from HPV (condyloma accuminata)

Question 8

List some neoplastic lesions of the penis.

Answer 8

Malignant: squamous cell carcinoma. risk factor HPV 16, 18. Histology see infiltrating islands of squamous cells with keratin pearls.

Question 9

List some non-neoplastic lesions of the testes.

Answer 9

Congenital: cryptorchidism (undescended testes)
Inflammation: torsion, occurs post trauma

Question 10

How are testicular tumours (neoplasms) classified and why?

Answer 10

Into seminomatous and non-seminomatous as the former is radiosensitive whereas the latter is not. Also, seminomatous tumours tend to spread via lymph nodes, whereas non-seminomatous tend to spread via blood stream, particularly to lung. Non-seminomatous tumours include teratoma, yolk sac tumour, choriocarcinoma, and embryonal carcinoma.

Question 11

Briefly describe the macroscopic and microscopic histological features of a seminoma.

Answer 11

Seminoma most common in 20-40 y.o.
Macro: painless, unilateral, bulky testicular enlargement with homogenous, creamy white appearance. Usually NO haemorrhage or necrosis.
Micro: sheets of tightly packed cells with dark central nuclei, priminent nuclolus and clear cytoplasm, often surrounded by characteristic lymphoid infiltrate.

Question 12

What is a teratoma?

Answer 12

A tumour arising from an embryonic cell layer, resulting in a haphazardous mass of skin, hair, cartilage, and or bone

Question 13

Which type of non-seminomatous tumour secretes alpha fetoprotein?

Answer 13

Yolk sac tumour.

Question 14

Which type of non-seminomatous tumour secretes human chorionic gonadotropin (HCG)?

Answer 14

Choriocarcinoma, also some seminomas.