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AA Sal Abdominal Radiology > Male Reproductive > Flashcards

Male Reproductive Flashcards

1
Q

Associations w/ unilateral kidney (men)

A

Zinner syndrome (seminal vesicle cysts), prostate utricle cyst

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2
Q

Zinner syndrome. Association

A

Absent kidney, seminal vesicle cysts. Can also have other structures missing (vas deferens). Can have ectopic ureters. a/w PCKD

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3
Q

Seminal vesicle cyst

A

Off-midline. a/w Zinner syndrome

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4
Q

Prostate utricle cyst location. Communicates w/ what? Associations?

A

Midline. Communicate w/ urethra (can have urine in them), can have cancer. a/w hypospadias, cyrpochidism, unilateral renal agenesis

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5
Q

Male pelvic cysts (2)

A

Midline; prostate utricle cyst. Lateral; seminal vesicle cyst

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6
Q

Vascular disease of testis (2)

A

Testicular torsion, Segmentl infarction.

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7
Q

Testicular torsion. Deformity that predisposese to torsion. Ultrasound findings.

A

Bell-clapper deformity predisposes to torsion due to small testicular bare area. Ultrasound findings: Hyperacute: shadowing torsion knot, no flow. Acute: testicle is enlarged/heterogenous. Missed Torsion (>24 hours); effected testicle is enlarged, mottled, w/ scrotal thickening and increased flow in the scrotal wall.

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8
Q

Segmental infarction. Etiology, clinical presentation, ultrasound appearance.

A

May be due to microvascualar thrombosis from acute inflammation, vasculities, or sicke cell. May mimic torsion cinically. Wedge shaped hypoechic area w/ no flow on doppler.

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9
Q

Scrotal trauma (3 entities)

A

Hematoma, testicular contusion, testicular rupture.

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10
Q

Testicular contusion appearnce on u/s

A

Peripheral hypoechoic lesion that may mimic tumor.

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11
Q

Testicular rupture appearance on u/s

A

capsule disruption. Timely diagnosis is critical.

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12
Q

Scrotal infection (3)

A

Epididymitis, epidiymo-orchitis (infection that has spread from epididymis to testicle. Inflammation can cause focal testicular ischemia.) Fournier gangrene (necrotizing fasciitis of scrotum and perineum. Key finding is subcu gas).

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13
Q

Where is base and Apex of prostate?

A

Base is superior. Apex is inferior.

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14
Q

3 zones of prostate

A

Peripheral, transitional, central

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15
Q

What is central gland of the prostate?

A

Central zone and transitional zone. The transitional jones enlages as BPH develops.

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16
Q

Where are most cancers of prostate?

A

Peripheral zone (70%). Transitional zone (20%)

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17
Q

Classic prostate cancer MR imaging

A

In peripheral zone, T2 dark, restricts diffusion, enhances.

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18
Q

Appearance of transitional zone prostate cancer

A

“erased charcoal” appearance. Appears smudgy.

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19
Q

MR Spectroscopy of prostate cancer would show

A

Elevated Choline and depressed Citrate.

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20
Q

Difference in TZ tumors, PZ tumors, and BPH.

A

TZ tumors (erased charcoal). PZ tumors (more discrete). BPH nodules: T2 hetrogenous w/ clear margins

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21
Q

Non neoplastic Ddx for PZ T2 hypointensity (3)

A

Prostitis, hemorrhage, involution changes from androgen therapy.

22
Q

Hemorrhage in prostate MR imaging (can persist up to 8 weeks post biopsy)

A

T1 hyperintense. T2 Hypointense, NO ENHANCEMENT.

23
Q

Prostate cancer enhancement pattern

A

early enhancement relative to parenchyma.

24
Q

Prostate cancer critical stage

A

Stage B is abutment without bulge. Stage C is Bulge or Frank Extra-capsular extension.

25
Q

Corpus cavernosum vs. Corpus Spongiosum

A

Corpus cavernosum is the 2 circles that get engorged. Corpus spongiosum is less engorged b/c it contains urethra

26
Q

Tunica Albuginea surrounds which part of the penis

A

Corpus cavernosum

27
Q

What is fractured in a fractured penis?

A

Tunica Albuginea

28
Q

Complication of fractured penis

A

Peyronies (bent penis).

29
Q

2 findings on RUG

A
  1. Gonococcal stricutre long/irregular stricture in bulbous urethra. 2. Straddle injury: short segment stricture of bulbous urethra.
30
Q

Tubular ectasia of rete testis facts.

A

Common benign finding. Results from obliteration of efferent ducts. Usually bilateral and in older men.

31
Q

Varicocele. Primary and secondary.

A

Primary is incompetent valves of internal spermatic vein. Secondary is increased venous pressure from obstructing lesion. Most are and left sided.

32
Q

What is next step for Right sided varicocele. What is concern

A

Next step - more imaging. Concern is RCC (most common), RP fibrosis, or nutcracker syndrome

33
Q

epididymal cyst vs. spermatocele

A

Spermatocele is cystic dilatation of epididymis filled w/ spermatozoa. Classic appearance is a cyst w/ low level internal echoes. Cannot always be distinguished from simple epididymal cyst.

34
Q

Tunical cyst clinical presentation.

A

Cyst of tunica albuginea. Presents as palpable superficial nodule that resembles a BB.

35
Q

Epidermoid cyst in testicle (aunti minnie)

A

“onion skin” appearance. Relatively nonvascular compared to rest of testis. Benign.

36
Q

Ddx testicular masses (8)

A
  1. Malignant Germ cell tumor: Seminoma. 2. Malignant germ cell tumor: nonseminomatous Germ cell tumor.3. Burnt-Out Germ cell tumor. 4. Microlithiasis. 5. Mets (lymphoma) 6. Benign testicular tumors. 7. Sarcoid. 8. Benign testicular tumor mimimics
37
Q

Breakdown of intratesticular masses in young white males

A

95% germ cell (5% sex-cord stromal). Of the germ cell tumors, seminoma and non-seminoma are 50/50.

38
Q

Difference in appearance of Seminoma and NSGCT/Teratoma

A

Seminoma is heterogenous w/ no calcifications. NSCGCT is heterogenous w/ cysts and calcifications.

39
Q

Seminoma demographics

A

Most common testicular malignancy. Middle-aged men. Good prognosis.

40
Q

Nonseminomatous germ cell tumor - 5 types. Which is most common?

A

embryonal carcinoma, teratoma, yolk salc tumor, choriocarcinoma, mixed types. Mixed germ cell tumor is most common (usualy embryonal + teratoma)

41
Q

NSGCT demographics

A

Younger patients (20’s, 30’s), compared to seminomas. Heterogenous testicular mass with solid and cystic components.

42
Q

Malignant Testicular mass in an older male (60’s) is likely to be

A

lymphoma

43
Q

Burnt out germ cell tumor. What is it, appearance, treatment.

A

primary testicular neoplasm that is no longer viable in the testicle, but there are viable mets. Focal calcification w/ shadowing. Treatment is orchietomy and systemic chemo.

44
Q

Microlithiasis

A

controvertial association w/ neoplasm. If less than 5 microcalcifications, its called “limited microlithiasis”

45
Q

Testicular mets (most common ones?)

A

Leukemia and lymphoma (relevant chemotherapeutic agents do not cross blood-testis barrier.

46
Q

Benign testicular tumors (2)

A

Epidermoid. Sex-cord stromal tumors

47
Q

sex cord stromal tumors (2 types and their associations)

A

Leydic cell tumor - gynecomastia due to estrogen. Sertoli cell tumor - Peutz-Jeghers and Klinefelter

48
Q

Testical cancer: demographics of who is more likely to get it. where do they drain?

A

White male w/ undescended testicles. Drain to para-aortic lymph nodes.

49
Q

Testuclar cancer mimic

A

Sarcoid, congenital adrenal rests (newborns w/ congenital adrenal hyperplasia), and polyorchidism/supernumary testis.

50
Q

Which is more malignant? Intratesticular vs. extratesticular masses

A

Intratesticular more likely malignant. Except in pediatrics, an extratesticular mass may be malignant.

51
Q

2 common benign extratesticular masses

A

Spermatic cord lipoma. Benign adenomatoid tumor of Tunica albuginea.

AA Sal Abdominal Radiology (6 decks)

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