male pathology Flashcards
(117 cards)
1
Q
Acute bacterial prostatitis etiology
A
Same as UTI
2
Q
Acute bacterial prostatitis pathogenesis
A
Organisms ascend from urethra and urinary bladder Rarely, hematogenous spread
3
Q
Acute bacterial prostatitis morphology
A
Acute inflammation in the glands with micro abscess, congestion & edema
4
Q
Micro abscess are aggregation of ____ in the glands
A
Neutrophils
5
Q
Acute bacterial prostatitis clinical course
A
Dysuria, frequency, low back pain & pelvic pain.
The prostate is enlarged and exquisitely tender.
+/- fever, chills, or Leukocytosis.
6
Q
Prostate size in Abp
A
Enlarged
7
Q
Which is more common bacterial or abacterial chronic prostatitis
A
Abacterial
8
Q
Bacterial chronic prostativies etiology
A
Same as acute
9
Q
Abacterial chronic prostatitis etiology
A
Chlamydia, trichomonas & ureaplasma urealyticum
10
Q
Chronic prostatitis morphology
A
Lymphocytic infiltrate, PMN & macrophages, Some evidence of tissue destruction
11
Q
Where does nodular hyperplasia occur
A
Transitional &periurethral zones
12
Q
Most common age for bah
A
Over 70
13
Q
What’s the main hormone in Bph
A
Dihydrotestosterone
14
Q
Estrogen role in nodular hyperplasia
A
Increase in older men cause an increase in DHT receptors
15
Q
BPH clinical course
A
Only in 10%, hesitancy, urinary retention & elevated PSA
16
Q
BPH treatment
A
5 alpha- reductase type 2 inhibitors
: Transurethral resection of prostate tissue to relieve the obstruction
17
Q
Enzyme that convert testosterone to dihydrotestosterone
A
5 alpha reduces type 2
18
Q
Is BPH premalignant
A
BPH is not a premalignant condition and is not precursor of carcinoma
19
Q
___% of BPH cases contain incidental carcinoma
A
10%
20
Q
PSA > 4ng/ml
A
Carcinoma, BPH, Prostatitis, After biopsy
21
Q
PSA can be used for:
A
Monitoring success of Prostatectomy
Detecting early relapses & DDx of other malignancies
22
Q
Most common visceral CA in Male
A
Carcinoma of the prostate
23
Q
2nd most common cause of CA death in men.
A
Carcinoma of the prostate, 20%
24
Q
Peak incidence of clinical prostate CA
A
65-75 years
10% at 50 y & 80% at 80 y
25
in which race is prostatic carcinoma more common
black
26
prostatic carcinoma clinical features
Often clinically silent, (start at the peripheral zone)
Urinary obstructive symptoms → extensive prostate CA
27
75% of prostatic cancer patients present in what stage
C&d
28
Diagnosis of prostatic cancer
Routine surveillance in men over 40 yr
Incidental finding in Transurethral Resection of the Prostate TURP
Adenocarcinoma with unknown primary
rarely , rectal or perirectal mass.
29
Metastases in prostatic carcinoma
osteoblastic bone lesions.
30
Prostatic cancer clinical course
Digital rectal exam (DRE), PSA: > 4 ng/ml in peripheral blood (Free PSA < 25%)
Transrectal ultrasound, Needle biopsy (hard mass on the peripheral zone).
Metastases
31
free PSA in prostatic cancer
<25%
32
Prostate carcinoma pathology
Yellow-white hard multifocal foci with predilection for peripheral zones
Haphazard small irregularly shaped invasive glands with abortive lumens.
Glands lack basal cell layer & Cells contain prominent nucleoli
Perineural invasion.
33
Prostatic intraepithelial neoplasia
precursor lesion for prostatic adenoCA & no invasive component, but the glands have malignant cells
34
At which stage needle biopsy start
3
35
What's well differentiated score in Gleason scoring
2
36
What's well differentiated score in Gleason scoring during needle biopsy
6
37
Abnormal location of the urethral orifice
Hypospadias & epispadias
38
Hypospadias
Ventral aspect, common, associated with genital abnormalities
39
Epispadias
Dorsal & rare
40
Abnormal location of the urethral orifice clinical consequences
Constriction of orifice, UT obstruction, UTI
impaired reproductive function
41
Sexually transmitted inflammatory lesions most commonly caused by
HPV
42
Banalities etiology
Poor local hygiene in uncircumcised men
43
Define banalities
Inflammation of the glans with prepuce
44
Smegma
Accumulation of desquamared epithelial cells, sweat & dermis
45
Banalities clinically
Distal penis is red, swollen, tender, +/- purulent discharge
46
Define phimosis
Prepuce can't easily be retracted over glans
47
Paraphimosis
Associated with urethral constriction
48
Phimosis etiology
Congenital, balanoposthiris & scarring
49
Trapped glans
Paraphimosis
50
Fungal infections etiology
Poor local hygiene especial diabetics, warm moist conditions
51
Fungal infections clinical course
Erosive, painful, pruritic & can involve entire male external genital
52
Fungal infections diagnosis
Scraping or biopsy
53
Fungal infections microscopy
Budding yeast & pseudohyphae
54
Condyloma acuminaram etiology
St, HpV 6 (common) & 11
55
Condyloma acuminatam microscope
Abnormal squamous cells & koilocytic changes
56
Condyloma acuminariam benign or malignant
Design
57
Penile carcinoma etiology
HPV 16 & 18
58
Bowen Disease _____ age of 35
Above
59
Bowenoid populaces ___ age of 35
Below
60
Solitary plaquelike lesion
Bowen disease
61
Multiple red brown populous
Boweroid populaces
62
Incidence of Bowen disease to become invasive carcinoma
%10
63
Incidence of bowenoid populaces to become invasive carcinoma
Never
64
Erythroplasia of Queyrat
erythematous patch on the glans
65
Squamous cells carcinoma incidence
1% in uncircumcised men 40 -70
66
Scc affects
Glans & prepuce
67
SCc pathogeneis
Poor hygiene, Smegma (exposure to potential carcinogens) HPV (16,18) /Environmental irritants (coal tar, soot)
CIS first then progression to invasive SCC
68
SCc clinical course
Usually indolent, Locally invasive, rare distant metastasis 25% of cases has spread into inguinal lymph nodes
69
Scc survival
5 years, 70% without Ln 27 % with
70
Scrotal enlargement syndromes
Hydrocele, hematocele & chylocele
71
Which testis is more common to have crytorchidism
Right
72
Cryptorchidism hormonal etiology
Deficient of lhrf, intrinsic testicular abnormalities
73
Cryptorchidism mechanical etiology
Short spermatic cord or blocked inguinal canal
74
Crypoorchidism morphology
Smaller than normal testes
Hypoplastic or atrophic germinal layer of tubules
Leydig cell hyperplasia, Thickened BM
Intratubular germ cell neoplasia
75
Crypbochridism management
Orchiopexy
76
causes of Testicular atrophy
Chronic ischemia, inflammation or trauma & Hypopituitarism
Excess female sex hormones: Therapeutic administration & Cirrhosis
Malnutrition, Irradiation & Chemotherapy
77
cryptorchidism ____ fold ↑risk of testicular malignancy i
4
78
Nonspecific epididymitis & orchitis etiology
Secondary to UTI
79
Nonspecific epididymitis & orchitis clinically
swelling & tenderness, Acute inflammatory infiltrate
80
Mumps clinically
Edema, congestion & chronic inflammatory infiltrate
81
Tuberculosis
Granulomatous inflammation and Caseous necrosis
82
Seminoma metastasity
5%- 10 %
83
Seminoma median age
25 - 50
84
Seminoma of testicular GCT
35% - 50%
85
Testicular tumor peak age
15-34
86
Testicular tumors risk factors
Cryptorchidism, testicular feminization syndrome, Klinefelter syndrome, siblings, cytogenic abnormalities
87
most important cause of painless enlargement of testis
Testicular tumor
88
In what race is testicular tumor more common
White
89
One histological partner testicular cancer
60% seminoma (30%) emburyonal, yolk sac, choricarcinoma & teratome
90
multiple histological partner testicular cancer
(40%): Embryonal CA, teratoma, Choricarcinoma + other, Other combinations
91
Large cells with distinct cell borders
Seminoma
92
Large cells with indistinci cell borders
Embryonal carcinoma
93
Seminoma microscopy
large Cells (clear or granular Cytoplasm) with Distinct cell borders (CM)
Round nuclei and conspicuous nucleoli
Lymphocytic infiltrate (T) and granulomas are common
94
Is seminoma pure or mixed
Pure
95
Seminoma metastasis to
Iliac & para aortic lymph nodes
96
In seminoma, the precursor of GCT is _____
present
97
In spermatocyric seminoma, the precursor of GCT is _____
Absent
98
Positive plap test
Classical seminoma
99
Intratubular component in spermatocytic seminoma
False
100
Differentiation in seminomatous
Gondola
101
Differentiation in embryonic carcinoma
Totipotential
102
2nd most common GCT
Embryonal carcinoma 20% - 30%
103
Embryonal carcinoma mixed or pure
Mixed
104
Embryonal carcinoma presentation
Pain or metastasis (even if small).
105
Embryonal carcinoma grossly
Invasive hemorrhagic masses with necrosis
106
Embryonal carcinoma microscopically
solid nests or gland like structures
Large Cells with indistinct cell borders (undifferentiated cell (Embryonal)) Basophilic cytoplasm, large nuclei and conspicuous nucleoli
107
Most common testicular tumor below the age of 3 years
Yolk sac tumor
108
Yolk sac tumor microscopically
Cub & columnar cells forming sheets, Glands, papillae & microcysts.
Schiller Duval bodies (2 layers of cells & in the middle there is BVs)
Hyaline globules are also common
109
Differentiation in teratoma
Somatic
110
Postpubertal
Malignant
111
Prepubertal
Benign
112
Differentiation in Choriocarcinoma
Trophoblastic
113
The worst GCT prognosis
Choriocarcinoma
114
Choriocarcinoma morphology
Often small non palpable tumor with wide spread metastases
Cytotrophoblasts & syncytiotrophoblasts in a hemorrhagic background.
115
Non seminomas Mets to
Lymph nodes, liver & lung
116
Most radiosensitive tumor
seminoma
117
Where does prostate cancer arise
Peripheral zone
