Pathology Flashcards
hypospadias
most comm congenital anomaly of penis, failure of the tissue to properly fuse on the ventral surface of the penis. 1 in 300-500. Can interfere with nml urethral and ejaculatory function. anomalies tend to occur in clusters, if this then look for others as well.
phymosis
difficulty retracting the foreskin, may cause chronic inflammation, remove foreskin to tx,
-paraphymosis is the opp problem.
Can be related to poor hygiene, STDs
circumcision debate
since 1975 the amer. acad. of peds has stated that there is no routine medical indication for circ, but the sociocultural norm dictates that 60-75% of newborn males are still circ. not a medical decision usually.
condyloma
warty-cauliflower-like growths anywhere that sexual contact occurs. Most commonly caused by HPV 6+11. Hist: have papillary app. and are hyperkeratotic, but orderly and no mitoses
Carcinoma in situ, penis (on skin is called Bowen dz) (on glans is erythroplasia of Queyrat) all the same thing.
-most commnly caused by HPV 16 + 18. Hist: heaped up cells in abnomal orgnaziation, hyperkeratotic, mitoses, disorganized maturation of the cells from basal layer upward, elongated rete ridges.
10% progress to carc.
sq. cell carc. of penis
not as comm as that of cervix. assoc with HPV but also with smoking (conc of toxins in urine and also handling of penis with same fingers used to handle cigarettes) and poor hygiene
cryptorchidism
Undescended testicle, us. unilateral, can be true (in normal path) or ectopic (outside of normal path. Risk of infertility (despite the other normal testis), trauma (when in a more exposed area like the pelvic brim), infection, incr. risk of germ cell cancer in both the affected testis and the other (whether or not the first is removed). Correct b4 3 years of age.
Histology of cryptorchidism
the undescended testis will show fairly normal sertoli cells but lack the nml spermatozoa, poss b/c too warm
Kleinfelter syndrome
XXY genotype, mental retardation, feminization incl. no facial hair, breast develpmt, long arms and legs, small testes, infertility.
Hist of kleinfelter in testes
normal leydig cells but no sertoli cells and no sperm. may look like hyperplasia of leydig cells but probably this is just that there are no sertoli cells to compare them too so it looks like more and abnormal organization.
mumps, testes
can lead to orchitis, tubular sclerosis and focal atrophy of part or whole of testis. Can cause infertility in varying degrees. Other infections can cause orchitis or epididymitis
what stage of syphyllis affects the testes?
tertiary, spirochetes visible under special lighting. this progresses the opp. direction of TB or gonorrhea from testis to epidid.
TB in testis is rare
us. retrograde from prostate and epididymis. tthat is all.
Granulomatous orchitis
autoimmune us. following gram - infection, middle aged M, intratublar granuloma form in the histology
testis regression - VINDICATE
Vascular, Inflammation, Neoplasm, Degenerative, Intoxication, Congenital, Autoimmune, Trauma, Endocrine
testis torsion
the spermatic cord becomes twisted, cutting off the blood supply(no alternative blood supply) and causing ischemia and (white) infarction if not corrected w/in 4-6 hrs. (true emergency)
-may be assoc w/ anatomical excess mobility (ballclapper phenom) which means if one side twists, the other is likely to at some point also
Control of testis descent
from abdm to pelvic brim = MIH, from the brim to scrotum = androgen failure occurs in the latter in 90-95% of cases.
age group for test. CA
mid 20s to 30s
the vast majority of test. CA are _______ and should be _________
malignant, removed
most test. CAs are _________ cell tumors and most are ________ lines not pure.
germ, mixed
Most comm germ cell tumor, most commonly appearing “pure” form
Seminoma,
Seminoma characteristics.
us. homogenous “fried egg” cells, not us necrotic or hemorrhagic, us. have no defining architecture but are simply arranged in sheets, grossly tend to be well-circ, tan to white, and bulg out of the plane of the cut
T/F Most testic. CA are very mitotically active.
True. this makes them esp. susceptible to radiation and chemo, which are nevertheless secondary to removal of the testis.
embryonal carcinoma
us mixed, more aggressive than seminoma, more likely to be invasive, hemorrhagic, necrotic.
Hist: cells us. have some architecture (variable), much more anaplastic appearing cells
