Path: Male Genital Flashcards
What are the congenital anomalies of the penis?
hypospadias - urethra opens ventrally
epispadias - urethra opens dorsally
What is phimosis?
inflammatory disorder of penis - orifice of prepuce too small to retract over glans
due to scarring or dev anomaly
can lead to hygiene problems, accumulation of smegma –> inf, maybe carcinoma
What are the 3 tumors of the penis and their associations?
condyloma acuminatum - HPV 6 and 11
carcinoma in situ - HPV 16
invasive carcinoma (squamous cell) - HPV 16 and 18
What are the clinical variants of penile carcinoma in situ?
bowen dz: scaly, shaft and scrotum, 10% progress to invasive
erythroplasia of queyrat: red plaques, glans, 10%
bowenoid papulosis: younger, rare progression, can spontaneously regress
What are the clinical features of penile invasive carcinoma?
circumcision confers protection
typically 40-70
metastasizes to inguinal and iliac nodes
squamous –> keratin pearls!
What are predisposing factors for testicular torsion?
increased mobility to to absence of gubernaculum or atrophy
What is seen w testicular torsion?
red and hemorrhagic parenchyma
coagulative necrosis
What are sequelae of cryptorchidism?
atrophy and sterility
10X increase of germ cell tumors - bilateral risk even if unilateral cryptorchidism
What are the different types of testicular tumors?
most are germ cell tumors
seminoma or non-seminomatous (embryonal carcinoma, yolk sac tumor, teratoma, chorciocarcinoma)
Compare and contrast seminomas vs. non-seminomatous tumors of the testicles.
pure vs. mixed histology
orchiectomy and RADIOtherapy vs. orchiectomy and CHEMOtherapy
no serum markers (LDH nonspecific) vs. HCG & AFP
lymphatic spread vs. lymphatic & hematogenous
low stage presentation vs. high stage
What are the morphologic highpoints of classic seminoma?
sheets polygonal cells, clear cytoplasm, prominent cherry red nucleoli separated by fibrous bands w lymphocytes
What are the morphologic highpoints of embryonal carcinoma?
pleomorphic epithelioid malignant cells forming gland-like structures, mitotic features
What are the morphological high points of yolk sac tumor?
perivascular rosettes = schiller-duval bodies
AFP!
What are the morphological high points of choriocarcinoma of the testes?
admixture of syncytio- and cytotrophoblasts - need both
hCG!
What are inflammatory conditions of the prostate?
acute and chronic bacterial prostatitis: e. coli
chronic abacterial prostatitis: most common, maybe chlamydia, ureaplasma
What are the features of BPH?
does not predispose to cancer, DHT and estrogen accumulation
What is the role of 5alpha-reductase in the pathogenesis of BPH?
converts testosterone into DHT
What can help diagnose prostate cancer?
hypoechoic areas on ultrasound
PSA >10 - but more specific ways:
PSA density, velocity, or percent free PSA (lower w cancer)
PSA can help monitor response to therapy
What are etiological factors in the dev of prostate cancer?
common in African Americans, rare in Asians
1st degree relatives at increased risk, fatty diet?
What is the pathology of prostate cancer?
mostly adenocarcinomas
spread by lymphatic and hematogenous: lots to bone - osteoblastic!
peripheral nodules (BPH more central)
What is seen microscopically w prostate cancer?
back to back gland proliferation
large nucleus w cherry red nucleoli
pink amorphous secretion
perineural invasion
What is prostatic intraepithelial neoplasia (PIN)?
premalignant lesion of prostate - graded as low or high grade, but only high grade usually found
