Male GU Pathology Flashcards
Normal prostate wt
Gland divided into 3/4 zones: __, __, __, ____
cancers usually originate in the ___, hyperplasia in the ___ zone
Normal glands have 2 layers___ (myoepithelial) and ___
20g
central, transitional, peripheral, anterior fibromuscular stroma
peripheral zone, transitional zone
basal, secretory
Acute bacteial prostatitis
UTI orgs from __ spread from ___
CM: ___, ___, ___
acute inflam w ___, often forming __ and __
__ is contraindicated
urine reflux, bladder
fever, chills, dysuria
PMNs, microabscesses, necrosis
biopsy
chronic bacterial prostatitis
CM: __ or __ and __
Recurrent __
Dx requires inc __, complaints of ___
usually not preceeded by __
Chronic abacterial prostatitis
inc ___ but no ___ of secretions
asx, low back pain, dysuria
UTIs
WBC, prostatic secretions
acute prostatitis
wbc, complaints
Granulomatous prostatitis
may mimic ___
rxn to __ or secondary to ___ therapy for bladder ca
__ occurs in immunocompromised indiv
carcinoma
extravasated secretions, BCG
fungal
Nodular hyperplasia aka __
Not ___
Multinodular prolif of both __ and __ that can compress ___
Prostate cancer more common in \_\_\_ Incidental foci found in majority of men over \_\_ more common in \_\_ than \_\_\_ \_\_ more than \_\_
Etiology is ___
BPH
premalignant
stromal/glandular, urethra
older men >50y
70yr
US, asia
AA, Caucasian
unknown
Prostate cancer CM
usually ___, esp in ___
advanced dz may present w ___ or __ secondary to mets
Detected by ___ and __
__ useful for monitoring response to therapy/recurrence
PSA is a __ produced by normal/cancerous ___
elevation may occur w __ and __ and ___ (not specific)
not useful in isolation for initial ___
but is excellent __ for cancer after tx
asx, peripheral cancers
urinary sx, back pain
digital rectal exam, PSA
PSA
serine protease, prostate epithelium
cancer, BPH, prostatitis
dx
follow up
Prostate cancer definitive dx w ___
histology: __ or __ glands w prominent ___ and no ___
graded by ___
morph patterns assigned __, and 2 predominant patterns __ for total
__ correlates w prognosis
majority of cancer is ___
staging depends on extent of ___
local to __or ___
metastasizes to __ (esp __) aka
Or __ LN
biopsy
haphazard/fused, nucleoli, basal layer
Gleason score
numbers, summed
grade
peripheral
tumor spread
seminal vesicles, bladder
bone, spine, osteoblastic lesions
pelvic
Prostate cancer tx \_\_ \_\_ via external beam/brachytherapy \_\_ Hormonal manipulation such as \_\_ or \_\_\_ inhibit
prostatectomy
xrt
watchful waiting
orchiectomy, LHRH inhib
Cryptorchidism
___ testes
inc susceptibility to __ and __ and ___
inc risk of ____
often spontaneously descend during ___, if persistent, __ required, usually before age ___
arrest of descent is in ___ and testis lies w/in
undescended
trauma/atrophy/infertility
testicular tumors
1st year, surgery, 2
inguinosacral phase, inguinal canal
atrophy of testes
end stage of processes such as __ or __ or __ or __
Gross appearance: ___ testis
Micro: thick, __ tubular BM
decrease in __, slight inc in __
bilateral atrophy leads to __
vasc, hormonal, inflam, developmental
small, firm
hyalinized, germ cells, Leydig cells
sterility
Epididymitis/Orchiitis
more common in __
usually __ UTI/STD via __ or __ lymphatics
Organisms __, __, __, ___, __, __ (uti org)
gonorrhea and TB affect __ then testis
syphillis affects __ then ___
epididymis
2ndary, vas/cord
Chlamydia, gonorrhea, TB, syphillis, mumps, Ecoli
epididymis
epididymis, testes
Torsion
Twisting of ___ disrupts blood flow
__ more susceptible than __, resulting in __ w __ infarct
most common in __ or adult w ___ (inc mobility)
Urologic emergency- untwisting w/in __ can salvage
attach __ to __ to prevent future torsion (orchiopexy)
spermatic cord
veins/arteries, engorgement, hemorrhagic infarct
neonates, adults w anatomic defect
6hr
testes, scrotum
Germ cell tumors
majority of __
__ but ___
typical age range
Caucasian:AA ratio
Characteristic finding ___
or mets
most are ___
Predisposing factors
C
T (XXY)
G
Characteristic cytogenetic abnorm ___ seen in all __ and also in __ GCT
testicular tumors
aggressive, curable
15-34y
5:1
painless testicular mass
mixed
cryptorchidism
testicular dysgenesis
genetics
i(12p), histo types, ovarian
Germ cell tumors
precursor lesion ___ (ITGCN)
almost all ___ have ITGCN
exceptions __ and ___
Rare in __
untreated, progresses to __ in 5yrs
can tx w ___ if foudn
types include S, Y, E, T, C
most important to differentiate __ from __
Seminomas are ___, less __, more __ than NSGCT
intratubular germ cell neoplasia
adult tumors
spermatocytic seminoma, dermoid
peds
invasive GCT
low dose radiaition
seminoma, yolk sac, embryonal, teratoma, choriocarcinoma
seminoma, nonseminoma
lower stage, hematogeous spread, radiosensitive
Seminoma MC \_\_, most likely to be \_\_ identical to ovarian \_\_ \_\_ prognosis Gross: gray white \_\_\_ mass, no \_\_ or \_\_
micro: Lobules of large __ w distinct ___ and abundant ___
fibrous __ w assc ___
Spermocytic seminoma
not a ___
pts usually > than __
not assc w ___, never __
Histo: 3 __ cell pops
includes __ and __ and __ cells
GCT, pure
dysgerminoma
best
homogenous, hemorrhage/necrosis
uniform cells, nucleolus, clear cytoplasm
septae, lymphs
classic seminoma
65y
ITGCN, mets
admixed
medium, small, giant
