Male Pelvis Pathology Flashcards
most extratesticular masses are _____
benign
most intratesticular masses are ___
malignant
what is the most common cancer of the testicles?
seminoma
seminoma spread to draining lymph nodes in the ____
retroperitoneum
stage 1 of seminoma
confined to the testis
stage 2 of seminoma
spread to retroperitoneal nodes BELOW diaphragm
stage 3 of seminoma
spread beyond retroperitoneal nodes ABOVE diaphragm
risk factors of seminoma (6)
cryptorchidism
family history of testicular cancer
infertility
Klinefelter syndrome (XXY)
trisomy 21
smoking
lab values of seminoma (3)
↑ BHCG
↑ AFP
↑ LDH
what is the most common secondary malignancy of the testicles?
lymphoma
nonseminoma consists of ___
other cell types besides germ cells
what is the second most common testicular cancer?
embryonal carcinoma
what is the most aggressive testicular cancers?
embryonal carcinomas
lab values of embryonal carcinoma
↑ AFP
↑ BHCG
what is the most common testicular cancer in infants and children?
yolk sac tumors
what are the 4 kinds of nonseminomas?
embryonal carcinoma
yolk sac tumors
teratomas
choriocarcinomas
yolk sac tumors are also known as
endodermal sinus tumors
lab values of yolk sac tumors
↑ AFP
what is composed of all 3 germ layers?
teratomas
lab values of teratomas
↑ AFP
↑ BHCG
what is the least common testicular cancer?
choriocarcinomas
lab values of choriocarcinomas
↑ BHCG
what are leydig cell tumors?
rare testicular tumor that produces testosterone which results in precocious puberty
leydig cell tumors are always ____ in boys 5 to 10 years old
benign
lab values of leydig cell tumors
normal AFP, BHCG, and LDH
intratesticular cysts originate from the ___
rete testis
intratesticuar cysts occur near the ___
mediastinum testis
intratesticular cysts measurements
2 to 18 mm
tunica albuginea cysts appear in the __ and __ aspects of the testis
lateral and anterior
tunica albuginea cyst measurements
2mm to 3cm
2 types of testicular cysts
intratesticular cysts
tunica albuginea cysts
epidermoid cysts are also known as
keratocysts
epidermoid cyst measurements
1 to 3 cm
ultrasound appearance of epidermoid cysts (3)
“onion ring”
“bow tie”
“target”
what is testicular microlithiasis?
“scrotal pearls” between layers of the tunica vaginalis or within the testicles
T/F: testicular microlithiasis is usually unilateral
FALSE: testicular microlithiasis is usually BILATERAL
testicular infarct presents as __
a triangular-shaped avascular intratesticular lesion
what is a hydrocele?
serous fluid that accumulates within the tunica vaginalis or between the layers of the tunica vaginalis
congenital hydroceles are common in what ages of boys
1 to 2 years old
what is the most common cause of painless scrotal swelling?
hydrocele
T/F: there is no color flow in a hydrocele
true
what is a varicocele?
dilation of the pampiniform venous plexus
what is the most common correctable cause of male infertility?
varicocele
90% of varicoceles are on the __ side
left
varicoceles may produce aching pain with __ or __
prolonged standing or heavy lifting
varicoceles increase vein diameter with valsalva
> 2 mm
when bowel protrudes through the inguinal canal into the tunica vaginalis
scrotal hernia
the presence of __ confirms the diagnosis of scrotal hernias
peristalsis
what is the most common extratesticular tumor?
adenomatoid tumor
where are adenomatoid tumors found?
tail of the epididymis
what are spermatoceles?
dilation of the epididymal tubules
spermatoceles are filled with __
thick milky fluid containing sperm
spermatoceles usually found in the ___
epididymal head
what is tubular ectasis of the rete testis?
bilateral dilation of the mediastinal tubules
tubular ectasis of the rete testis are frequently associated with ___
spermatocele
tubular ectasis of the rete testis are more common in men over
55 years old
appearance of tubular ectasis of the rete testis
microcysts within the testicles
what is the most common cause of acute scrotal pain?
acute epididymitis
causes of epididymitis/orchitis (2)
GC/CT in men under 35 years old
UTIs in prepubertal boys and men over 35 years old
epididmitis appearance (4)
enlarged hypoechoic epididymitis
hyperemia
reactive hydrocele
scrotal wall thickening
orchitis appearance (3)
enlarged hypoechoic testicle
hyperemia
decreased arterial resistence
testicular torsion occurs in (2)
adolescents and neonates
testicular torsion causes an sudden onset of severe ___
severe unilateral scrotal pain
testicular torsion varies between __ to __ degrees
180 to 540 degrees
decreasing __ will optimize slow blood flow to rule out complete testicular torsion
decrease PRF
intravaginal testicular torsion is when
the testicle is not attached to the tunica vaginalis or when the testicle has high attachment
intravaginal testicular torsion causes
bell clapper deformity = testicle can rotate freely on the spermatic cord
extravaginal testicular torsion is when the __
testis and gubernaculum can rotate freely
extravaginal testicular torsion occurs exclusively in
newborns
time between the onset of pain and testicular detorsion and the corresponding salvage rate:
< 6 hours -
12 to 24 hours -
> 24 hours -
< 6 hours - 90 to 100% salvage
12 to 24 hours - 20 to 50% salvage
> 24 hours - 0 to 10% salvage
what is priaprism?
painful erection that lasts for more than 4 hours
ischemic priaprism is when
blood get trapped in erection chambers
ischemic priaprism occurs more often in men with (3)
sickle cell anemia (42%)
leukemia
malaria
what drugs can also cause priaprism (5)
depression meds
mental illness meds
erectile dysfunction meds
marijuana
cocaine
what is peyronie’s disease?
fibrous scar tissue inside the penis that causes curved, painful erections
peyronie’s disease is associated with (4)
Dupuytren’s disease (trigger finger)
plantar fascitis
sjogren syndrome
scleroderma
side of the penis that touches the belly
dorsal/posterior
side of the penis that is scanned
ventral/anterior
prostate cancer risk in men is about
15%
prostate cancer incident increases with (3)
age
family history of prostate cancer
race
african americans are ___% more common to have prostate cancer
60%
PSA density =
PSA density = PSA level / prostate volume
ultrasound appearance of prostate cancer (2)
hypoechoic
peripherally-oriented
3 methods of prostate biopsy
lesion directed biopsy
systemic sextant biopsy
parasagittal sextant biopsy
which prostate biopsy method is based on a sonographic lesion and has a poor detection rate?
lesion directed biopsy
which prostate biopsy method takes 3 on the right and 3 on the left?
systemic sextant biopsy
which prostate biopsy method includes additional biopsy cores in the lateral aspects of the peripheral zone?
parasagittal sextant biopsy
stage 1 of prostate cancer
small lesion
low PSA
low Gleason
stage 2 of prostate cancer
lesion in prostate
medium PSA
stage 3 of prostate cancer
lesion outside of prostate
high PSA
stage 4 of prostate cancer
metastatic
spread to lymph nodes, bones, or organs
BPH occurs in the ___ zone of the prostate
transitional zone
BPH is common in males ___
50+ years old
treatment of BPH (2)
transurethral resection of the prostate (TURP)
open simple prostatectomy
utricle cysts are ___ shaped
pear-shaped
utricle cysts are ___ location at the level of the ___
midline location
level of the verumontanum
utricle cyts communicate freely with the ___
prostatic urethra
utricle cysts are associated with (3)
hypospadias - opening of the urethra not at the tip of the penis
cryptorchidism
unilateral renal agenesis
müllerian duct cysts are ___ shaped
tear-drop shaped
müllerian duct cysts are ___ location extending above the ___ posterior to the ___
midline location
extending above the prostate posterior to the bladder
müllerian duct cysts DO NOT communicate with the __
prostatic urethra
ejaculatory duct cysts are ___ in location
lateral in location
ejaculatory duct cysts result in (3)
hematospermia
ejaculatory pain
infertility