Male Reproductive Pathology

Question 1

portals of entry for pathology

Answer 1

1. direct contact
2. ascending infection
3. hematogenous localization (most common)
4. peritoneal spread

Question 2

are more reproductive tract protective mechanisms innate or adaptive

Answer 2

innate - fast acting, non-specific

Question 3

what are the 5 defense mechanisms of the reproductive tract

Answer 3

1. tubular and interstitial fluid content
2. epithelial cell barrier
3. flushing/movement
4. cremaster muscle
5. convoluted testicular artery

Question 4

what are the main responses to injury of the reproductive tract

Answer 4

inflammation (swelling, heat, pain, redness, loss of function)

repair (fibrosis and resolution)

leads to spermatic granulomas

Question 5

how does inflammation lead to spermatic granulomas

Answer 5

inflammation damages the testicular blood barrier (Sertoli cell junctions) causing haploid sperm to be exposed to blood

immune response to haploid sperm is to form a granuloma to attack the sperm

Question 6

what are the categories of reproductive pathology

Answer 6

1. non-infectious (developmental vs acquired)
2. infectious
3. neoplastic

Question 7

testicular hypoplasia

Answer 7

developmental disorder resulting in smaller than normal testes for the age of the animal

hypoplastic tubules lined only by sertoli cells

Question 8

cryptorchidism

Answer 8

incomplete descent of the testes into the scrotum
- unilateral
- genetic
- reduced spermatogenesis
- predisposed to neoplasia

hypoplastic tubules lined only by Sertoli cells + fibrosis

Question 9

segmental aplasia of the mesonephric duct

Answer 9

aplasia of the epididymis leading to inability of sperm to leave the testis

leads to sperm accumulation, destruction of the ducts, and immune exposure to the sperm

results in spermatic granulomas

can maintain fertility if unilateral

Question 10

paramesonephric duct remnants

Answer 10

cystic remnants that can cause compression atrophy of adjacent structures

no clinical significance if no compression

Question 11

polled intersex syndrome (PIS)

Answer 11

genotype XX with testes (often cryptorchid)

caused by mutation in FOXL2 gene

occurs in polled breeds of goats

Question 12

mullerian duct syndrome

Answer 12

genotype XY with intersex phenotype (cryptorchid testes + uterus)

caused by a mutation in AMHR2

occurs in miniature schnauzers

Question 13

freemartinism

Answer 13

when the female in a set of male/female twins gets exposed to AMH and testosterone produced by the male twin via anastomosis of the placental vessels

results in female pseudohermaphrodite (external female w/ male internal genitalia)

Question 14

developmental structural defects

Answer 14

altered androgen concentrations or lack of androgen receptors leading to defects in the scrotum and penis
- preputial adhesions
- persistent frenulum
- hypospadia

Question 15

testicular degeneration/atrophy

Answer 15

acquired; decrease in testicular size that occurs after puberty

caused by toxins, viruses, etc

unilateral atrophy w/ contralateral hypertrophy

Question 16

spermatic granuloma of the epididymal head

Answer 16

acquired; sterile, non-infectious, congenital disorder resulting in inflammation from extravasated spermatozoa

causes infertility from obstruction of epididymis

Question 17

bulbourethral gland hyperplasia

Answer 17

consumption of phytoestrogens (in certain pastures) stimulates hyperplasia of the BU gland

occurs in grazing animals

Question 18

prostate hyperplasia

Answer 18

hormone related hyperplasia of the prostate gland

can be caused by excess estrogens which stimulate diffuse hyperplasia and metaplasia

secondary effects: dorsal deviation and obstruction of the colon

occurs in dogs with age; often seen w/ Sertoli cell tumors

Question 19

phimosis

Answer 19

inability to extrude the penis

Question 20

paraphimosis

Answer 20

inability to retract the penis

Question 21

priapism

Answer 21

persistent erection

Question 22

penile ruptures

Answer 22

erectile tissue + high pressure during erection can lead to rupture and hemorrhage

Question 23

pampiniform plexus varicocele

Answer 23

abnormal dilation of the spermatic vein in the pampiniform plexus

occurs in older rams

Question 24

what species is orchitis and epididymitis common in

Answer 24

rams and dogs

Question 25

what are the most common causes of infectious pathology

Answer 25

brucella species herpesviruses horses: salmonella or strep equi/zoo

Question 26

pathogenesis of infectious pathology

Answer 26

infection --> infarction --> adhesions --> fibrosis and atrophy

Question 27

orchitis

Answer 27

inflammation of the testes caused by hematogenous spread of bacteria leads to spermatic granulomas often has concurrent epididymitis

Question 28

epididymitis

Answer 28

inflammation of the epididymis (tail always affected) - unilateral - acute: swollen, soft - chronic: enlarged, firm (fibrous tissue/granulomas) leads to spermatic granulomas

Question 29

pathogenesis of epididymitis

Answer 29

epididymitis --> testicular degeneration --> atrophy of the testes --> infertility

Question 30

periorchitis

Answer 30

inflammation of the structures surrounding the testes

Question 31

balanitis

Answer 31

inflammation of the glans penis

Question 32

posthitis

Answer 32

inflammation of the prepuce

Question 33

balanoposthitis

Answer 33

inflammation of the penis and prepuce common in castrated animals

Question 34

what species/age is reproductive neoplasia most common in

Answer 34

older dogs

Question 35

germ cell neoplasia

Answer 35

seminomas, teratomas

Question 36

seminomas

Answer 36

tumor of the germ cells - homogenous, white/pink/gray, firm, bulges when cut - abundant large, nucleated cells on histology - usually benign common in older horses and dogs

Question 37

leydig cell tumors

Answer 37

interstitial tumor of leydig cells - spherical, well demarcated, semi-firm/soft, tan to yellow, bulges on cut surfaces - can have regions of hemorrhage - usually benign common in bulls, dogs, cats

Question 38

Sertoli cell tumors

Answer 38

tumor of sertoli cells - well circumscribed, firm, white, lobulated, causes enlargement of affected testis - abundant fibrous tissue - usually benign; can spread to regional LNs leads to HYPERESTROGENISM common in dogs

Question 39

hyperestrogenism

Answer 39

high estrogen leading to feminization - gynecomastia (enlarged mammary glands) - endocrine alopecia - hyperplasia/squamous metaplasia of the prostate - myelotoxicity

Question 40

myelotoxicity

Answer 40

high estrogen inhibits myelopoiesis (bone marrow suppression) leading to aplastic anemia and thrombocytopenia

Question 41

prostatic carcinoma

Answer 41

carcinoma of the prostate (ONLY neoplasm in the prostate) - malignant - poor prognosis - enlarged prostate invades nearby structures - metastasizes to LNs, lungs, possibly bone

Question 42

penile habronemiasis

Answer 42

lesion caused by aberrant migration of the larvae of habronema muscle and draschia megastoma depositing on the penis/prepuce leads to an ulcerated mass on the penis/prepuce (similar to granulation tissue or sarcoidosis) occurs in horses