Male Reproduction (path) Flashcards
Hypospadias
opening of urethral canal on VENTRAL surface of penis (failure of urogenital folds to close correctly)
Cause: genetic and environmental, common
Complications: UTIs, infertility
Epispadias
opening of urethral canal on DORSAL side of penis
Cause: abnormal (low) positioning of genital tubercle
Complications: bladder exstrophy, UTIs, infertility
Phimosis
orifice of prepuce is too small for normal retraction.
= congenital, w/ inflammatory complications (infection/scarring, cancer)
condyloma accuminatum
= genital warts (benign)
from HPV 6 or 11 (low risk types)
–> koilocytic changes in nuclei of infected cells
Penile Intraepithelial Neoplasm (PIN)
benign squamous hyperplasia of penis, usually w/ HPV infection. *NOT invasive
grades I-III (III = “Bowen disease” - full thickness affected)
Squamous Cell Carcinoma (of penis)
malignant squamous neoplasm,
Risk factors: high risk HPV infection (16, 18, 31, 33), no circumcision, *Bowen disease = precursor
** high risk vascular spread!
Testicular torsion
twisting of the spermatic cord
–> venous obstruction, hemorrhagic infarction
* Dx: absent cremasteric reflex
Risk Factors: incomplete descent, absent scrotal lig, small testis
Lesions of tunica vaginalis
hydrocele (serous fluid build-up) - incomplete closure of process vaginalis, can be trans-illuminated.
Hemocele (blood build-up)
Lymphocele (chyle build-up)
Lesions of the ductus afferentes or rete testis
spermatocele - abnormal sperm drainage
varicocele
Dilation of spermatic vein bc impaired drainage.
“bag of worms” appearance,
** most often left side (bc drains into L renal v), & assoc. w/ renal cell carcinoma
Cryptorchidism
incomplete migration of testis (“undescended”);
most = inguinal, abdominal or suprascrotal less so.
Complications: tubular atrophy & fibrosis, increased risk torsion & testicular cancer.
testicular ectopia
when testicle(s) migrate to the WRONG place (not even along normal path of descent)
pre-testicular causes of infertility
hypopituitarism, testicular exhaustion (after prolonged FSH)
testicular causes of infertility
Genetic: Klinefelter (XXY)
Developmental: cryptorchidism, anorchia, ectopia
Systemic: Diabetes, cirrhosis, malnutrition
Other: atherosclerosis, varicocele, EtOH, chemo/radiation
Post-testicular causes of infertility
= lesion/blockage to excretory ducts (congenital, inflammatory or iatrogenic)
Acute Epididymitis
= neutrophilic, complication of UTIs (bacterial)
Path: neutrophil infiltrate, tissue destruction/fibrosis
*may spread to testes
Chromic Epididymitis
= lymphocytic, post-infection from mumps, influenza, varicella,.etc.
Idiopathic Granulomatous Epididymitis
interstitial and intertubular granulomas, mimic neoplasms;
Cause: autoimmune (?)
* most common cause of granulomatous orchitis in USA
Tuberculous granulomatous Epididymitis
epididymitis followed by orchitis, secondary to pulm. TB;
Path: caseous necrosis => post-inflamm. fibrosis
Sperm granuloma => granulomatous epididymitis
granulomatous reaction to extravasated sperm (from trauma), in M <40.
Classic Seminoma
= most common type of testicular germ cell tumor, Age: ~40s, mets to lymph nodes 1st
Histo: large, uniform cells w/ clear cytoplasm & lymphocytic infiltrate
* VERY radiosensitive!
Intratubular Germ Cell Neoplasia (“ITGN”)
in situ lesion of testicle that typically preceeds malignant germ cells tumors.
* = isochromosome 12p (gene mut on short arm)
Spermatocytic Seminoma
seminoma (germ cell tumor) NOT assoc. w/ i12p.
Histo: mix of 3 cell sizes
* mets = rare, very good prognosis
Non-seminonatous germ cell tumor types (4)
- Embryonal carcinoma
- Yolk Sac tumor
- Choriocarcinoma
- Teratoma
* most often = mised types, more aggressive.
Peak age: 30 yrs old
