Male path (robbins) Flashcards
What is the most common male malformation?
Hypospadias-> opening on ventral surface of the penis
What are the complications/ associations with Hypospadias?
Infections
Inguinal hernias
Undescended testis
What is balanitis and balanoposthitis?
Local inflammation of glans penis and overlying prepuce
MCC of balanitis?
Candida albicans
Anaerobes
Gardnerlla
pyogenic bacteria
Condition in which the prepuce cannot be retracted?
Phimosis–> Often 2nd to balanosposthitis
MC penile neoplasm and factors?
Squamous carcinoma
Poor hygiene (smegma formation)
Smoking
HPV 16+18
Difference btwn SCC in situ and invasive in the penis?
in situ (Bowen disease)--> solitary, plaque on shaft No invasion of stroma
Invasive-> gray, crusted, papular, on Glans or prepuce. invasion producing ulcers
What is the MCC of scrotal enlargement?
Hydrocele–> collection of fluid within Tunica vaginalis
What is Cryptorchidism?
Failure of the testes to descend into the scrotum
1% of all 1yo infants + 10% bilateral
What are the complications of Cryptorchidism? Both Unilateral + bilateral?
infertility
3-5x increased risk of Testicular Cancer
Nonspecific epididymitis + orchitis usually are 2nd to what other condition?
UTI that spread through urethra or lymphatics
Difference between orchitis due to UTI and mumps?
UTI–> predominantly PMN infiltration
Mumps–> Lymphocyte infiltration
What is the MCC of granulomatous inflammation in the Testes (epididymis)?
TB
Adult male pt with sudden testicular pain associated with anatomical defect?
Torsion–> caused by increased testicular movement called the BELL Clapper abnormality
How long are the testis viable during torsion?
6 hrs
What are 95% of testicular tumors?
Germ cell tumors (seminomas)
Malignant
What are sex-stromal tumors?
neoplasms derived from Sertoli and Leydig cells
What are some of the risk factors for Germ cell tumors?
White
Cryptorchidism
Intersex syndromes (androgen insensitivity and gonadal dysgenesis)
FHx (increased by 8-10x)
50% of germ cell tumors histologically Identical to Ovarian Dysgerminomas and CNS germinomas
Seminomas
What is the genetic association to all Germ cell tumors?
Isochromosome on short of chromosome 12
i(12p)
Peak age 40-50, sheets of polygonal cells with clear cytoplasm, lymphocytes in the stroma, 10% have elevated hCG?
Seminoma
Peak age 20-30, poorly differentiated, pleomorphic cells in cords, sheets, or papillary formation; contain yolk sac and choriocarcinoma cells?
Embryonal carcinoma
Peak age 3 yo, poorly differentiated endothelium-like, cuboidal, or columnar cells, 90% associated with elevated AFP?
Yolk sac tumor
Peak age 20-30, Cytotrophoblast and syncytiotrophoblast without villus formation, 100% with elevated hCG?
Choriocarcinoma
peak age 15-30, variable, depending on mixture, commonly teratoma and embryonal carcinoma, 90% with elevated hCG + AFP?
Mixed tumor
Soft well-demarcated, gray white tumors that bulge from the cut surface of the affected testis. Large uniform cells with distinct cell borders, clear, glycogen rich cytoplasm and round nuclei with conspicuous nucleoli?
Seminoma
15% of seminomas are associated with what?
Synctiotrophoblasts= elevated hCG
What is the organism causing Syphilis?
Spirochete–> Treponema pallidum
What is the sequelae of HPV in males?
Cancer of penis