male reproductive system Flashcards
is a congenital abnormality in which one or both testes are not found in their normal position in the scrotum. Theoretically could be related to (a) developmental disorders of gonad, (b) endocrine factors or © mechanical factors that prevent the passage of the fetal testis through the inguinal canal.
Cryptorchidism, clinically known as undescended testis
descent of the testes depend on
mullerian inhibiting substance and androgen
complications of cyptorchidism (2)
- sterility
2. malignancy
is cryptochidism common?
1% occurrence
germ cell tumor:
seminoma and spermatocytic seminoma
seminomatous tumor of testicular origin
germ cell tumor:
Embryonal carcinoma
Yolk sac (endodermal sinus) tumor
Choriocarcinoma
Teratoma
non-seminomatous tumors of testicular origin
leydig cell tumor and sertoli cell tumor
sex cord- stromal tumors of testicular origin
If there is no potential for differentiation- ________ will be developed. If there is a potential for further fetal tissue differentiation tumor progression to ___________ can occur
If there is no potential for differentiation- seminoma will be developed. If there is a potential for further fetal tissue differentiation tumor progression to embryonal carcinoma can occur
predisposing factors for testicular cancer
- cryptorchidism
- testicular dysgenesis
- white>blacks
- isochromosome or extra 12p- germ cell tumors
extra copies of 12p associated with tumor progression and treatment failure, particularly in _____________ germ cell tumors
non-seminomatous
what is the percent of ITGCN development of cancer in 5 years
50%
Routine pathway starting from ITGN does not play a role in these tumors (3)
- Spermatocytic seminoma >65years
- Childhood: <4 years – yolk sac
- Prepubertal: 4-13 years - teratoma
peak incidence of seminoma
30s
giant cells are present in 10% to 20% of seminomas. They are usually randomly scattered in the tumor and not associated with cytotrophoblastic cells unlike choriocarcinoma. They are responsible for modest elevations of b-HCG seen in some seminomas.
Syncytiotrophoblastic
Schiller-Duvall body is a structure seen in the ________ pattern of yolk sac tumor.
endodermal sinus
is the 2nd most common testicular germ cell tumor in children
Teratoma
tumor that comprises at least two types of germ cells tumors with or without ITGCN.
Mixed GCT
serum markers that are routinely evaluated in all testicular tumors (4)
- AFP
- HCG
- LDh
- > 80% of NSGCT positive at time of diagnosis
serum marker assessing tumor burden
LDH is a prognostic indicator
leydig tumors may produce
- androgens
- estrogens
- corticosteroids
leydig tumor cells can lead to malignancy in __%
10
“In post pubescent males, all teratomas are regarded as malignant regardless of whether the elements are mature or immature
yep
identify tumor:
Older men
Very low malignant potential.
No ITGCN precursor
spermatocytic seminoma
Serine protease, functions to
liquify semen.
PSA is produced by? and secreted in?
Produced by prostatic epithelium, secreted in semen.
where is the location of BPH? what is involved
- Stroma + glands involved
- Affects the INNER portion of the prostate, around the urethra/transitional zone
rapid rise in PSA think of
malignancy
precursor of prostatic adenocarcinoma
prostatic intraepithelial neoplasia- 80% have PIN in gland occuring in the peripheral zone
Recent studies have shown that some prostate cancers contain recurrent chromosomal aberrations
TMPRSS2/ERG fusion
gleason score of 7-10
poorly differentiated, high grade which is usually advanced and unlikely to be curable
Back to back irregular glands with nuclei containing prominent nucleoli
Adenocarcinoma/Embryonal carcinoma
Large monomorphic lymphoid cells with scant cytoplasm, large nuclei and prominent nucleoli
Non Hodgkin lymphoma
Diffuse suppurative inflammation with gram negative rods on gram stain
Suppurative orchitis
Full thickness epithelial dysplasia with intact basement membrane
Seen on squamous /transitional epithelium
Islands of cartilage, squamous epithelial pearls and glands lined by tall columnar epithelium
Teratoma
Nests of large polyhedral cells with watery cytoplasm and large nuclei with prominent nucleoli, surrounded by lymphoid stroma
Seminoma
Rounded cells with abundant granular eosinophilic cytoplasm containing crystalloids of Reinke
Leydig cell tumor
Syncytiotrophoblast and cytotrophoblast arranged in sheets with extensive hemorrhage and necrosis
Choriocarcinoma
