Pathology Lecture 3 Flashcards
what is the main tumour of the penis
95% are squamous cell carcinomas
erythroplasia of queyrat
- non-keratinising squamous cell carcinoma in situ
- glans and prepuce of the penis are most commonly involved
presentation of erythropalsia of query
velvety red plaques on the glans penis and the inner prepuce
bowens disease
- keratinising squamous cell carcinoma in situ
- pigmented lesions affecting follicle bearing areas of the penile shaft and scrotum
in both erythroplasia of query there is
full thickness dysplasia of the epidermis
how many erythroplasia of queryat and bowens disease progress to invasive squamous cell carcinoma
only 5%
squamous cell carcinoma of the penic occurs almost exclusively
in uncircumcised men
aetiology of squamous cell carcinoma
poor hygiene and human papilloma virus type 16 and 18
squamous cell carcinoma of the scortum seen in who
chimney sweeps caused by exposure to soot
benign prostatic hyperplasia affects
at least 75% of men over the age of 70 but only 5% have significant symptoms
BPH is caused by
irregular proliferation of the glandular and stroll prostatic tissue
aetiology of BPH
hormonal imbalance, alteration of the androgen/ oestrogen ratio because as you get older the amount of testosterone falls and the levels of oesoregn increase
what part of the prostate gland is particularly responsive to oestrogen
the central part which is whereto hyper plastic mostly occurs
the hyperplasia can cause
a bladder outlet obstruction causing prostatism resulting in urinary hesitance, poor stream and overflow incontinence
if untreated BPH CAUSES
Diverticulum formation and hydronephrosis
management of BPH
1ST LINE= LIFESTYLE MODIFICATIONS
2ND LINE= ALPHA BLOCKER (TAMSULOSIN), 5-DHT INHIBITOR (FINESTARIDE)
LAST LINE- TURP
Carcinoma of the prostate peak incidence
60-80
increased risk of carcinoma of the prostate if
first degree relative affected at a young age
carcinoma of the prostate is
not associated with BPH however, both tend to exist within the same gland
Carcinoma of prostate arises mainly
in the peripheral ducts and glands particularly at the posterior lobe, the peri-urethral zone becomes involved at a later staff
local spread of prostatic carcinoma
urethra, capsular, seminal vesicles, bladder and rectum
lymphatic spread of prostaitci carcinoma
sacral iliac and para-aortic nodes
blood spread of prostatic carcinoma
to the bone, lungs and liver
prostate cancer metastasises to bone and causes
OTOSCLEROTIC LESIONS RATHER THAN LYTIC LESIONS
TUMOUR MARKER FOR PROSTATE CANCER
prostate specific antigen
testicualr tumours
only accounts for 1% of cancer deaths but are the most common solid organ malignancy in young adult males
testicualr maldescent increases risk of testicuarl cancer by
10 fold
presenting complaint of testicular tumour
painless testicuarl enlargement can be associated with a hydroecel and gynaecomastias
classification of testicualr tumours
- Germ cell tumour are by far the most common accounting for 90%
- remaining 10% are lymphomas, leukaemia, stromal tumours (leydig and sertolli cells) of metastases
para-testicualr tours
adenomatoid tumours and sarcomas
germ cell tumours can be
seminomas teratomas or mixed
seminoma is the
commonest form of germ cell tumour accounting for 40% of germ cell tumours
seminomas are very rare
before puberty and most common between the age of 30-50
macroscopic appearance of seminoma
solid homogenous potato appearance
microscopic appearance
large clear tumour cell with variable stroll lymphocytic infiltration on microscopy
sminomas spread
lymphatic ally to the para-aortic nodes and can spread to th liver and the lungs
survival rate of seminomas
greater than 95% wit radiotherapy
tumour marker for seminoams
PLAP
Teratoma
accounts for 30% of germ cell tumours
teratomas consist of tissue from
all 3 germ layers: ectoderm, endoderm and mesoderm
peak incidence of teratoma
between the age of 20-30 but can occur in childhood
macroscopic appearance of teratomas
variable with solid areas cysts haemorrhage and necrosis
tumour marker for teratomas
beta- HCG
Mixed seminoma/ teratoma
accounts for 10% of germ cell tumours
- serinoma with any variant of a teratoma
