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patho II > Male Reproductive System (Ia) > Flashcards

Male Reproductive System (Ia) Flashcards

1
Q

————- : Abnormal opening of the urethra on the ventral aspect of the penis, anywhere along the shaft

A

Hypospadias

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2
Q

Complications of Hypospadias

A

Constriction → Urinary tract obstruction →
Increased risk for urinary tract infections

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3
Q

—————-: Abnormal opening of the urethra on the dorsal aspect of the
penis

A

Epispadias

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4
Q

———-: Inflammation of the glans penis

A

Balanitis

* happens normally in uncircumcised males

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5
Q

———– : Inflammation of the overlying prepuce (foreskin)

A

Balanoposthitis

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6
Q

causes of Blanoposthitis

A

1) Poor hygeine -> formation of smegma (shedding of skin)
2) Bacterial infection –> Candida albicans, anaerobic and pyogenic bacteria

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7
Q

Complication of Blanoposthitis?

A

Phimosis

* Phimosis –> tight foreskin (caused by scarring of the prepuce)

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8
Q

The most common Penile Neoplasm?

A

Squamous cell carcinoma >95%

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9
Q

Epi of Sqamous cell carcinoma (of the penis)

A

Associated w/ uncircumcised men >40yrs and HPV (16/18)

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10
Q

Squamous cell carcinoma is aka?

A

Bowen disease

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11
Q

Macroscopic Features:
* Solitary plaque on the penis’ shaft

Microscopic Findings:
* Malignant cells within the epidermis, without invasion of the underlying stroma
* Large pale keratinocytes with abundant ground cytoplasm (“pagetoid cells”)
* lymphocytic infiltrates

features of?

A

Bowen disease (SCC)

*SCC: squamous cell carcinoma in situ

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12
Q

Macroscopic Features:
* Gray, crusted, papular lesion; Occasionally, ulcerated with irregular margins
Microscopic Findings:
* Keratin pearls

features of?

A

Invasive squamous cell carcinoma

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13
Q

Microscopic Findings:
* Bulbous (rounded), pushing deep margins, and no atypia
* Thin fibrovascular cores
* Thick acanthotic epithelium

features of?

A

Verrucous carcinoma

* Varient of SCC (papillary architecture)

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14
Q

Progression of Verrucous Carcinoma

A

Local invasion, but no metastatic potential

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15
Q

———- : Accumulation of serous fluid within the tunica vaginalis

A

Hydrocele

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16
Q

———— : Accumulation of blood within the tunica vaginalis

A

Haematocele

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17
Q

———-: Accumulation of lymphatic fluid within the tunica vaginalis

A

Chylocele

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18
Q

Causes of Hydrocele

A

Neighbouring infections, Tumours

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19
Q

What Condition is caused by lymphatic obstruction (e.g. Filariasis) which results in → Marked enlargement of the scrotum and lower extremities ?

A

Elephantiasis

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20
Q

———– : Failure of testicular descent into the scrotum

A

Cryptorchidism

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21
Q

Epi of Cryptorchidism

A
  • 1% of male population (by 1 year of age)
  • ~10% of cases, bilateral involvement (Can be uni-/ bilateral)
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22
Q

Complications of Cryptorchidism

A

1) Sterility (impaired spermatogenesis)
2) 3-5-fold increased risk for development of testicular cancer

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23
Q

Microscopic Findings:
* Tubular atrophy (age: 5-6yrs); Hyalinisation (puberty)
* Foci of Intratubular Germ Cell Neoplasia (IGCN)

features of?

A

Cryptorchidism

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24
Q

Microscopic features:
* Small spermatic tubules
* Thickened basement membrane
* Atypical germ cells with clear cytoplasm
* Interstitial fibrosis

features of?

A

TESTICULAR ATROPHY & IGCN

* IGCN–> Intratubular Germ Cell Neoplasia

25
Q

Causes of Epididymitis?

* inflammation of the epididymis

A
  • Children–> Coliforms
  • Young men –> Neisseria gonorrhoeae and Chlamydia trachomatis
  • Older men –> E. coli and Pseudomonas
26
Q

Pathogenesis of Epididymitis

A

Primary urinary tract infection → Vas deferens or the lymphatics of the spermatic cord → Spread to the Testis

27
Q

Macroscopic Findings:
* Swollen and tender organ (Epididymus)
* Creamy fibrino-purulent exudate
Microscopic Findings:
* Neutrophilic inflammatory infiltrate

features of?

A

Epididymitis

28
Q

cause of Orchitis

* Inflammation of the testis

A

Mumps virus

29
Q

Macroscopic Features:
* Oedematous and congested testes

Microscopic Findings:
* Lympho-plasmacytic inflammatory infiltrate
* Extensive necrosis, atrophy, fibrosis and sterility (severe cases)

features of?

A

Mumps Orchitis

*Lympho-plasmacytic infiltrates = Virus

30
Q

Pathogenesis of Tuberculous Epididymo-Orchitis

A

Initially, Tuberculous Epididymitis → Extension to the
Testis →Tuberculous Orchitis

31
Q

Microscopic Findings:
* Granulomatous inflammation with caseous necrosis
* Giant cells

features of?

A

Tuberculous Epididymo-Orchitis

32
Q

Cause of Spermatic Cord Torsion in Adults

A

Failure of normal posterior anchoring (positioning) of the gubernaculum testis (“scrotal ligament”), epididymis and testis (bell clapper deformity) → Increased mobility of testes

33
Q

CF of Torsion of the Spermatic cord

A

Sudden onset of testicular pain

34
Q

Complications of Spermatic Cord Torsion

A

Obstruction of testicular venous drainage → Vascular engorgement & Venous infarction

  • Urologic Emergency!!
35
Q

Epi of testicular Neoplasms

A
  • Peak incidence: 15-35 years
  • Germ cell tumours account for 95% of testicular tumours in post-pubertal males
36
Q

Risk factors of Testicular tumours

A
  • History of Cryptorchidism
  • Brothers of males with Germ Cell Tumours –> 8-10-fold increased risk
37
Q

Pathogenesis of Testicular Neoplasms

A

Intratubular Germ Cell Neoplasia (IGCN) –> in situ lesion of Germ Cell Tumours

38
Q

Calssification of Testicular Neoplasms

A

1) Germ Cell Tumours
2) Sex Cord-Stromal tumours

39
Q

Germ cell Tumours examples

A

1) Seminomas (“Classic” Seminomas, Spermatocytic Seminoma)
2) Non-seminomatous Germ Cell Tumours (i.Embryonal Carcinomas, ii. Yolk-Sac Tumours, iii. Choriocarcinomas, iv.Teratomas)

40
Q

Sex Cord-Stromal Tumours

A
  • Sertoli-Cell Tumours
  • Leydig-Cell Tumours
41
Q

Macroscopic Features:
* Soft, well-demarcated, gray-white lesions (on the surface of the testicle)
* Large tumours: Foci of coagulation necrosis
* Lobular pattern

Microscopic Findings:
* Large, uniform cells with distinct cell borders
* Clear, glycogen-rich cytoplasm
* Round nuclei, with prominent nucleoli
* Arrangement of cells in small lobules, separated by fibrous septa
* Usually, lymphocytic infiltrates
* Sometimes, accompanying ill-defined granulomatous reaction
* Presence of syncytiotrophoblastic giant cells in 15% of cases;

feature of?

A

Seminomas

* Germ Cell tumour (Testicular neoplasm)

42
Q

what Hormon levels are elevated in Seminomas?

A

β-hCG (10% of patients) and PALP

* beta-human chorionic gonadotropin

43
Q

* Germ cell tumour

Epi of Spermatic Seminoma

A

> 65 years

44
Q

Microscopic Findings:
* Polygonal cells of variable size (i.e. lymphocyte-like cells, intermediate cells and giant cells)
* Arrangement of cells in nodules or sheets
* Absent lymphocytic infiltrates, granulomas and syncytiotroph.
* No association to Intratubular Germ Cell Neoplasia (IGCN)
* No metastatic potential

features of?

A

Spermatocytic Seminoma

* Gram cell tumour

45
Q

Epi of Embryonal Testicular carcinomas

A

RAREE

46
Q

Microscopic Findings:
* Small, ill-defined, invasive lesions
* Presence of haemorrhagic and necrotic foci
* Large, primitive looking cells
* Basophilic cytoplasm
* Large nuclei with prominent nucleoli
* Indistinct cell borders
* Arrangement of cells in solid sheets
* Presence of primitive glandular structures
* Admixtures with cells of other Germ Cell Tumours

features of?,

A

EMBRYONAL CARCINOMAS

47
Q

Epi of Yolk Sac Tumour

A
  • Most common primary testicular neoplasm in children <3yrs of age
  • In adults, these tumours are admixed with Embryonal Carcinoma
48
Q

Macroscopic Features:
* Large and well-demarcated lesions
* Low cuboidal to columnar cells
* Formation of microcysts, sheets, glands and papillae
* Schiller-Duvall bodies: Structures resembling primitive glomeruli
* Identification of PAS positive eosinophilic hyaline globules

features of?

A

Yolk Sac Tumours

49
Q

What Hormones are Elevated in Yolk Sac Tumours?

A

α1-antitrypsin and AFP (90% of patients)

50
Q

Macroscopic Features:
* Small, non palpable lesions
* lobulated and Haemorrhagic and necrotic lesions

Microscopic Findings:
* Sheets of small cuboidal cells, admixed with cytotrophoblast and syncytiotrophoblast-like cells

features of?

A

Choriocarcinomas

51
Q

Hormone levels elevated in Choriocarcinomas

A

hCG (+) in syncytiotrophoblast-like
cells
(100% of patients)

52
Q

Epi of Teratomas

A

Pure forms: Common in infants and children; Rare in adults (only 2-3% of Germ Cell Tumours)

53
Q

Microscopic Findings:
* Heterogenous collection of differentiated cells or organoid structures (e.g. neural tissue, muscle bundles, foci of cartilage and thyroid resembling tissue, brain substance, etc.) within a fibrous or myxoid stroma
* tissues may be mature (resembling adult tissues) or immature (resembling fetal tissues)

features of?

A

Teratomas

54
Q

List the 4 types of Teratomas

A

A. Neural (Ectodermal)
B. Glandular (Endodermal)
C. Cartilage (Mesodermal)
D. Squamous Epithelial

55
Q

Prognosis of Seminomas

A

Excellent prognosis (>90%)

56
Q

Prognosis of Non-seminomatous tumours

A

Excellent prognosis
(~90% of patients –> Complete remission and cure, with aggressive chemotherapy )

57
Q

Prognosis of Pure Choriocarcinoma

A

Poor prognosis

58
Q

CF of Seminomas and non-seminomatous tumours

A

Painless testicular mass

patho II (29 decks)

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