Pathology 3 Flashcards
What is the main purpose of the corpus spongiosum?
corpus spongiosum doesn’t expand as much as corpus cavernosum during an erection - keeps the urethra open and doesn’t allow it to collapse
Which invasion is worse in cancer?
Corpus cavernosum - as it has more vasculature
What is balanitis xerotic obliterans(BXO)/ lichen sclerosis?
very common
usually young patients
even neonates and kids & very old men
phimosis (foreskin that is stuck - red and swollen =, leading to painful urination)
paraphimosis –> can’t bring down the retracted foreskin
Histology of BXO
chronic inflammation/ scar tissue beneath the epithelium, hyalinisation and the foreskin in less pliable
What are the HPV viruses that cause benign genital warts?
HPV 6 and 11
What are the HPV viruses that cause high risk ones?
HPV 16 and 18
Neoplasia of the penis
PEiN - penile intraepithelial neoplasia
no grading
Undifferentiated PEiN causes
HPV related
Differentiates causes of PEiN
non HPV
Is penile cancer common?
NO
What is CIN?
Cervical intraepithelial neoplasia
Features felt on the testis
Lots of lumps and bumps paratesticular swellings testicular swellings Orchitis Torsion
What are the functional unit of the testis?
Semineferous tubule
What are the germ cells vs sertoli cells?
Germ cells –> produce sperms
Sertolid cells –> nourishment and environment within the tubules
Leydig cells-
What hormones stimulates the sertoli cells?
FSH
Sertoli only syndrome
No germ cells hence can’t do IVF as there are no sperms produced
What controls the Leydig cells?
LH
convert testosterone into the DHEA (dehydroepiandrosterone)
What is measured in hormone tests in athletes?
DHEA levels
Importance of DHEA
active form of testosterone
Are lumps common in the testis?
Yes
What is a hydrocoele?
Fluid accumulation btw the two layers of the tunica vaginalis - mesothelial lining
unicyctic, smooth and fluid filled
it is adjacent to the testis, not on it, so can palpate it superior to the testis
Examination and transilumination of the hydrocoele
smooth, softish, circunscribed, lucent
What is a spermatocoele?
Not in the trestis in the epidydimis
cystic change within the vas of the epidydimis
unknown cause and usually asymptomatic
feeling of fullness, full of sperm
What is a varicocoele?
Varisoties of venous plexus thatdrains the testis
usually asymtpmatic
may present with the feeling of a lump –> bag of worms
Guidance for examination
in the testis or seperate epidydimal or other if you can get above it -hernia solid of cystic (unicyctic - fost, - benign; if multicystic - malignant) painful - can be a red herring
Torsion
testis and cord rotate around the arterial blood supply
cell death exrtemely quick
after 6 hours - the testis is largely irretrievable
Bell clamper deformity
insertion of the tunica vaginalis is high - hence the testis is free in the scrotum
the testic can thus rotate and even sit laterally
PC of torsion
extreme excruciating pain
no particular precipitant
common in neonates and adolescents
can be in your sleep as much as in sports
Neoplasia in the testis
Lumps present in the testis proper
common tumour - ypunger age groups and more associated with malignancy
good prognosis - even at an advanced stage
responsive to chemo
What are the two types of tumours in the testis?
Seminoma and non-seminomatous
tumours of the germ cells
Most common testicular malignancy?
Seminomatous tumours - potato tumour on cutting it (white)
germ cell tumour- inflammatory infiltrates
What is the age group for seminomas?
20-40
Risk factora for seminomas
RF - undescended testis
contralateral testis also at risk
What is the cure rate for seminomas?
Excellent - 90%
surgery and extremely responsive to radiotherapy
Non-seminomatous tumour
less common
rarely exist as pure tumours
mixed types is the most common
vascular and cystic appearance
Age group for non-seminomatous tumours
30s
Agressiveness of non-seminomatous tumours
aggressive and can metastasize
even with mets the outcome is reasonable - very chemosensitive
have to treat ASAP - as they grow very fast
What is a mature teratoma?
Three germ layers
endoderm, ectoderm and mesoderm affected
all mallignant in testis (ovary –> benign)
Yolk sac tumour
produce AFP
endodermal sinus character
Embyonal
aggressive form, look high grade and is associated with freq mets
Trophoblast
wacky looking cells, positive for HCG
positive pregnancy test
What tells you if you got rid of the tumour or not?
tumour markers
What are the 4 types of non-seminomatous tumours?
trophoblast, yolk-sac, embyonal, teratoma
What is an inflammatory penile disease?
BXO
