Pathology of Male Reproductive System Flashcards
Condyloma Acuminatum
Prostate Chips of Transurethral Prostatic Resection
Where can you find the sessile or pedunculated papillomatous lesion caused by condyloma acuminatum of the male’s genatlia?(2-3points)
Coronal sulcus of inner surface of the inner surface of the prepuce
Squamous Cell Carcinoma
choriocarcinoma
epispadias
urethral orifice involving the dorsal surface
Choriocarcinoma
These little trabecular pattern are the storma. You’re going to find the lymphocytes or the granulomas at the darker part in the diagram to the left.
The little block dots in the picture to the right is a zoomed in picture are the lymphocytes.
choriocarcinoma
What gets larger in benign prostatic hypertrophy?**(2 points) **Why?
The glands and stroma, i.e., smooth muscle, of the prostate. DHT stimulates the growth of the smooth muscle of the blader and it grows larger
condyloma acuminatum
What is the aetiology of Bowenoid papulosis?
HPV type 16 DNA sequence have been detected
Granulomatous (autoimmune) orchitis?
unilateral testicular enlargement in middle aged men
What are androblastomas? What may these types of tumors eleborate?(2 points) What is the description of the cells?(2 points)
sertoli cell tumors; androgens or estrogen; tall columnar cells resembling seminiferous tubules
Nonseminomatous Germ Cell Tumors: what type of testicular tumor?(2-4 points) Can you treat with radiation? Can you treat with chemotherapy? What is the time course for the metastasis?(2 points) What is the prognosis?
choriocarcinoma, embryonal tumor, teratoma and yolk sac tumor; you can’t with radiation; they’re chemosensitive; early metastasis to retroperitoneal lymph nodes; poor prognosis, the tumors in this group are aggressive
What are the types and descriptiosn of each of the teratomas?(3 points)
mature teratoma - all elements well differentiated; immature - incompelte differentiation; teratoma - with malignant transformation
Acute Prostatitis
urethral orifice involving the ventral surface
hypospadias
Leydig Cell Tumor
Condyloma Acuminatum
Cryptorchidism
represents failure of descent
Benign Prostatic Hypertrophy
Blood in the tunica vaginalis
Hematocele
The most common cause of scrotal enlargement?
hydrocele
torsion of the testis
Carcinoma of the prostate
Leydig Cell Hyperplasia
Choriocarcinoma: how aggressive is the lesion; what type of elements are contained within the cells(2 points); what are the size of the lesions? How are the size of the testicles affected? This tumor is associated with elevated levels of what substance?
highly aggressive lesion; cytotrophoblastic and synctio-trophoblastic elements; small lesions; no testicular involvement; elevated levels of chorionic gonadotropin hormone
What is the description of the shaft of the lesion produced by squamous cell carcinoma of the male reproductive tract?(2-3 points)
ulcerinfiltrative exophytic verrucous lesion of the glans or shaft of the penis
What is the most common form of prostatis?
chronic abacterial prostatis, caused by ureaplasma urelyticum and chlamydia trachomatis
What is the aetiology of condyloma acuminatum?(2 points) What time in male’s life is this the most common? What is the gross morphology of the lesion?(2-3points) What location?(2-3)
HPV type 6 and 11; puberty; sessile, pedunculated papillamatous lesion; coronal sulcus of the inner surface of the prepuce
Seminomas: what type of testicular tumor? Can you traet with radiation? Can you treat with chemotherapy? What is the time course for the metastatsis? What is the prognosis?
it is a seminoma; it is radiosensitive; you can traet with chemotherapy; there is late metastasis; excellent prognosis
abnormally small orifice in the prepuce
phimosis
Carcinoma of the prostate
immature teratoma
hydrocele
hypospadias
urethral orifice involving the ventral surface
What is the most common testicular neoplasm in apteitns over hte age of 60 years?
testicular lymphoma
varicocele
cystic accumulation of blood within the spermatic cord
seminoma
What substance is usually elaborated when the prostatic carcinoma has metastasize?(2 points)
serum acid phosphatase and alkaline phosphate, the latter resulting with osteoblastic metastasis
What age range do you see the peak incidence of seminomas? What is the size and general shape of the cell? What is the description of the cytoplasm?(2 points) What is the description of the nucleus?(2 points)
You see the peak incidence in the fourth decade of life; large polyhedral cells; abundant and clear cytoplasm with glycogen present in cytoplasm; large nucleus with prominent nucleioli
mature teratoma
How do you treat benign prostatic hypertrophy?(1-2 points)
5α-reductase inhibitor or transurethral resection
osteoblastic bone lesions
Squamous cell carcioma of the male reproductive tract: incidence, it has indirect correlations with incidence of what procedure? What is the aetiology of the diseaes? What is the gross anatomical appearance of the lesion?(2-3 points) What is the location of the lesion?(2 points)
1% incidence; circumcision; HPV Type 16 and 18; ulceroinfiltrative exophytic verrucous lesion; glands or shaft
Trabecular Bladder
phimosis
lymphatic fluid in the tunica vaginalis
chylocele
What type of bacterial prostatitis: long standing or recurrent infection, may be asymptomatic or associated with low back pain and dysuria?
chronic bacterial prostatis
Hydrocele
clear serous transilluminating fluid accumulating within the tunica vaginalis
Are most cases of benign prostatic hypertrophy symptomatic or asymptomatic? What percentage reuqire surgery? What race is affeted 10 years earlier than the other: black or white? This is related to what hormonal imbalance?
symptomatic; 5-10%; blacks are affeted 10 years earlier than whites; there is sensitization for DHT and estrogen
Yolk Sac Tumor
embryonal carcinoma
Little tubules
Erythroplasia of Queyrat: what is the gross anatomical apperance and location of lesion?(3-5 points) What is the histology of the epithelia, generally speaking? What is the severity of the disease?
red, soft plaque of the prepuce or the glans; carcinoma in-situ
phimosis
abnormally small orifice in the prepuce
cyctisc accumulation of blood within the spermatic cord
varicocele
Acute bacterial prostatis are associted with what type of organisms? How do these organisms spread to the prostate?(2-3 points) The patients usually present with what symptoms?(3-5 points)
Organisms causing urinary tract infection; direct extension, hemotagenous spread or lymphatic spread; fever, chills, dysuria, boggy and markedly tender prostate
Yolk Sac Tumor
Balanoposthitis
non-specific inflammation of hte glans penis and prepuce
Squamous Cell Carcinoma
Carcinoma of the prostate
Cryptorchidism: incidence in male population? What is the aetiology for most cases? What is the aetiology for the other cases?(2-4 points) Does it affect both testes are just one testes?
0.7% incidence in male population; most cases it is idiopathic; other cases are caused by genetic abnormalitiesl ike trisomy 13, narrow inguinal canal or shortened spermatic cord; most cases the affect is unilateral
represents failure of descent
cryptorchidism
The histological changes you see in cryptorchism could be seen as early as what age?
two years of age
Nodular Hyperplasia
Non-specific inflammation of the glans penis and prepuce
Balanoposthitis
Carcinoma of the prostate
When it is poorly differentiated, you will see the pleomorphic figures and the mitotic figures.
Granulomatos (autoimmune) orchitis: onset? what type testicular mass? What do you find withi nthe testicular tubules?(3-4 points)
sudden onset; tender type of testicular mass; granulomas witthin testicular tubules and surrounding connective tissue along with lymphocuyte, plasma cells and neutrophils
Bowenoid papulosis: what is the appearance of the lesions? what is the aetiology of the diseaes?
multipigmented lesion; HPV type 16 association
What are the causes of testciular atrophy?(2-4 points)
cryptorchidism, vascular diseae, inflammatory disorcer and hypopituitarism
Nodular Hyperplasia
Yolk Sac Tumor: what is the microscopic apperance of the tumor?**(1-3 points) **How do you stain?
primitive glomerular-like structures which represent endodermal sinuses(Schiller-Duval Bodies); alphafetoprotein stain or alpha-1-antitrypsin
What age do you have the peak incidence for germ cell tumors? Germ cell tumor is more common in what racial group: blacks or whites? What is the classification and histogenesis of germ cell tumors?**(2 points) **The majority have what type of histological pattern?
14-34 years old; more common in white people; single histologic pattern or mixed histological pattern; the majority of cases have a single histological pattern
hydrocele
What is the most common form of cancer in males? It occurs predominantly in men over what age? It is more common in what races and less common in what race? What are the hormonal relationships?
prostatic carcinoma; over the age of 50 years old; it is more common in blacks and whites less common in asian population; administration of estrogen and castration
embryonal carcinoma
Due to the fact that it is aggressive you see areas of hemorrhage and necrosis.
ACute Epididymitis - GC
Clear serous transilluminating accumulation within the tunica vaginalis
hydrocele
What is the microscopic appearance for tumors of the male reproductive tract: pigment of the skin(2 points), nucleus and the cell?
There is hyperkeratosis and acanthosis of the skin in the male reproductive tract; there is rentention of polarity in the nucleus and there is koliocytosis
What is fusion of testis?
synchorism
torsion of the testis
What type of tumor: contains elements that represent more than one germ layer
teratoma
Carcinoma of the prostate
What are accompanying conditions you see with seminomas?(2 points) What is the general size and specific shape of the cell?(2 points) What is the description of the cytoplasm?(2 points)
lymphocytic infiltrations and granulomas; large polyhedral cell; abundant and clear cytoplasm with glycogen deposits present in the cytoplasm
Gonorrhea primarily affect what portion of the male reproductive tract? How does Mumps affect the male reproductive tract? How does syphillis affect the male reproductive tract? How does tuberculosis affect the male reproductive tract?
epididiymis; Mumps is an orchitis; syphillis is at first an orchitis but secondarily causes epididiymitis; Tubuerculosis initially an epididymitis with a secondary orchitis
What are the clinically significant features when it comes to cryptorchidism?(2-4 points)
infertility, exposed to trauma, usually accompanied by inguinal canal, testicular neoplasms
What specific portion of the prostate is affected in BPH?(3 points)
the inner periurethral portion of the prostate along with the lateral and medial invovlement
sertoli cell tumor
Embryonal Carcinoma: the peak incidence of this tumor is found in what age range? What is the relative agressiveness when compared to seminoma? What is description of the cells?(2-5 points)
20-30 years old; embryonal carcinomas are more aggressive than seminomas; cells in glandular, alveolar or tubular patterns with papillary convolutions at times
Where do prostatic carcinomas grow in the prostate?(2 points) What is the relationship to urinary tract obstruction? What is the consistency of the lesion? What is the microscopic apperance of hte glands?(3 points)
posterior aspect of the peripheral zone; there is no relationship to urinary tract obstruction; the lesions are “stony” hard; back to back glandular proliferation, single layer of cells surorund glands and there are varied levels of differentiation of the cells
Synchorism
fusion of testis
How does cryptorchidism affect testes reproductive function? What are the morphological changes of the spermatic tubules?(2 points) What are the morphological changes of the other tissue?** **What cells are affected and how are they affected?
there is arrest in spermatogenesis; there is marked hyalinization and basement membrane thickening of the spermatic tubules; there is interstitial fibrosis; there is Leydig cell hyperplasia
What is the pathogenesis of germ cell tumors?(2-3 points)
Cryptorchidism, testicular dysgenesis and genetic factors
Normal on the left and atrophic testis on the right
Tuberculous Orchitis
What condition is associated with marked Leydig Cell hyperplasia?
Klenfelter’s Syndrome
embryonal carcinoma
The arrow is pointing to the the blood vessel. It is showing you metastasis.
What is the incidence of Leydig (interstitial) cell tumors when compared to all of the testicular tumors? Most occurs between what age range? What type of substances may they elaborate? What are the typical microscopic features?(2 points)
2% out of all testicular tumors; 20-60 years old convey the peak incidence; they may elaborate androgens; typicaly microscopic features are eosinophilic Reink crystalloids and lipochrome pigment
spermatocele
cyctic collection of semen within the spermatic cord
Bowen’s Disease: this occurs over what age? How is the epithelium affected, generally speaking? How severe is the cancer?(2 points) It’s associated with what?
Bowen’s disease occurs over the age of 35; there is marked epithelial atypia; it is a carcinoma-in-situ but 10% of the cases transition to invasive cancer; it is associated with visceral malignancy
What carcinoma-in-situ is associated with visceral malignancy: erythroplasia of Queyrat or Bowen’s disease?
Bowen’s disease
Carcinoma of the prostate
What are the other causes of testicular atrophy?(2-4 points)
radiation and chemotherapy, malnutrition, Klinefelter’s syndrome and elevated lelve of female sex hormone
cytic collection of semen in the spermatic cord
spermatocele
Nodular Hyperplasia
Cryptorchidism increases the risk of testicular neoplasms by what amount?
10-40 fold increased risk
What is the most common testicular neoplasm in infants and children?
Yolk Sac Tumor
Normal testis on the left and atrophic testis on the right
What is an example of a seminoma variant? What general age group do you see a significant incidence? Does it metastasize? What type of tumor cells?
Spermatocytic seminoma; older people; no tendency to metastasize; tumr cells that resemble secondary spermatocyte
condyloma acuminatum
What type of test are used to evaluate the growth of carcinoma of the prostate? What are its disadvantages?
PSA, prostate specfiic antigen. The levels are also elevated in other prostatic conditions not related to carcinomas
Chylocele
lymphatic fluid in the tunica vaginalis
variety of organisms including anerobic bacteria and pyrogenic bacteria?
non-specific inflammation
hypospadias
What is the microscopic appearance of squamous cell carcinoma of the male reproductive tract?(1-2 points) How severe is the disease? What is the five-year survival rate for all stages?
Varying degree of differentiation with keratin pearls; distant metastases is uncommon; 70% five year survivial rate
bone metastasis
urethral orifice involving the dorsal surface
epispadias
