Male Reproductive Pathology Flashcards
Abnormal opening of penile urethra on VENTRAL surface of penis, due to failure of urethral folds to fuse. Associated with cryptorchidism and inguinal hernias
Hypospadias
Abnormal opening of penile urethra on DORSAL surface of penis, due to failure of urethral folds to fuse. Associated with bladder extrophy.
Epispadias
The SRY gene on the Y chromosome produces what?
Testis-determining factor
—> differentiates into sertoli and Leydig cells
What is the origin of the glans penis/clitoris?
Genital tubercle
What do Sertoli cells produce? What is the female homolog?
Secrete inhibin B —> inhibit FSH
Secrete Androgen binding protein—> maintain local levels of testosterone
-support sperm synthesis
—>granulosa cells
What do Leydig cells produce?
What is the female homolog?
Secrete testosterone in the presence of LH. TT is unaffected by temperature level
—> theca interna cells
What is being described: phenotypically normal, very tall, normal fertility. May be associated with severe acne, learning disability, autism spectrum disorders.
Double Y males - 47 XYY
What is the pathology: 46, XY or 46, XX - both with ovarian and testicular tissue present (ovotestis); ambiguous genitalia, previously called True Hermaphroditism.
Ovotesticular disorder of sex development
Clinically you find a male with a high riding testis, with long axis oriented transversely. Absent cremasteric reflex. What pathology is at hand? What is the TX?
Testicular torsion
TX-manually untwist
Bilateral orchiopexy within 6 hrs
What is the malignancy most associated with cryptorchidism?
35x increased risk for a germ cell tumor
15-35yr old PX presents with a painless homogeneous testicular enlargement. Histology demonstrates large cells in lobules with watery cytoplasm. Aka-fried egg appearance. Malignant. Usually radiosensitive, late metastasis, good prognosis.
Seminoma - MC germ cell tumor
Female equivalent- ovarian disgerminoma
PX presents a painful palpable mass in the scrotum, malignant. Histology shows cells more glandular, or have papillary morphology. AFP is usually normal, elevated hCG, or if a mixed cell type, can have both high. What pathology is at hand?
Embryonal carcinoma
This tumor is MC testicular cancer in children aged <3yrs. Appears yellowish and mucinous. Shiller-Duval: resembles primitive glomeruli, looks like a mesedermal core with a central capillary lined by visceral and parietal cells. Presents with elevated AFP. What pathology is at hand?
Yolk sac tumor
Px presents with elevated hCG. Histologically: disorganized syncitiotrophoblast and cytotrophyblast, thus elevated hCG. This tumor can metastasize hematogenously. Malignant. What pathology is at hand?
Choriocarcinoma
This testicular tumor is very rare, and presents with Reinke crystals (lipofusion), androgen producing—> gynecomastia (from hormone conversion), and seen with precocious puberty, and see a golden brown tumor.
Leydig cell tumor
