Prostate Flashcards
Where is the tunica vaginalis?
Exterior to the testes
There are 4 common lesions of the tunica vaginalis. What are they?
Hematocele
Chylocele
Spermatocele
Varicocele
Hematocele
Collection of blood usually from trauma
Chylocele and what is its association?
Collection of lymph
– associated with elephantiasis (lymph obstruction)
Spermatocele
Collection of semen in ducts
Varicocele
Dilated vein in the spermatic cord that looks like a bag of worms
What are the 4 zones of the Prostate?
Peripheral
Central
Transition
Periurethral
The prostate consists of ___ separated by fibromuscular stroma. What cell types are the ____ lined by?
GLANDS
- lined by cuboidal and overlying columnar secreting cells
What controls the growth and survival of the prostatic cells?
Testicular androgens
– thus castration causes atrophy of the prostate gland
Acute and Chronic Bacterial Prostatitis (inflammation) causing bacteria are similar to the common ones that cause?
UTI’s
What are the symptoms of Acute Bacterial Prostatitis?
Fever
Chills
Dysuria
Tender and boggy prostate
What are the symptoms of Acute Bacterial Prostatitis?
Fever/chills
Dysuria
Tender and boggy prostate
With Chronic Bacterial Prostatitis, what will the patient have a history of?
Recurrent UTI’s
What are the symptoms (if they have any) of Chronic Bacterial Prostatitis?
Lower back pain
Perineal/suprapubic pain
Dysuria
What are the symptoms (if they have any) of Chronic Bacterial Prostatitis?
Lower back pain
Perineal/suprapubic pain
Dysuria
With Chronic Bacterial Prostatitis, what will be present in the prostatic secretions and what will be result of the culture?
Leukocytosis in the secretions
(+) culture
What are the symptoms of Chronic Abacterial Prostatitis?
Same as Chronic Bacterial
= Lower back pain, perineal/suprapubic pain, dysuria
With Chronic Abacterial Prostatitis, is there a history of recurrent UTI’s?
NO
With Chronic Abacterial Prostatitis, what will be present in the prostatic secretions and what is the result of the culture?
Leukocytosis in the secretions
(-) culture
Granulomatous Prostatitis has many causes. What are the 3 most common?
- Instillation of BCG for bladder cancer treatment
- Reaction from secretions from ruptured prostatic ducts/acini
- Fungal
Granulomatous Prostatitis has many causes. What are the 3 most common?
- Instillation of BCG for bladder cancer treatment
- Reaction from secretions from ruptured prostatic ducts/acini
- Fungal
What zone does BPH affect?
Transition zone
= Compresses urethra
What zone does BPH affect?
Transition zone
= Compresses urethra
What is the main culprit that incites the events that lead to BPH?
Dihydrotestosterone (DHT)
With BPH, what cells does DHT activate?
Stromal cells
With BPH, DHT activates stromal cells. What molecules do stromal cells activate and what does that result in?
TGF-beta = epithelial cell death
IGFs, EGF, KGF = epithelial cell proliferation
When stromal cells (+) TGF-beta that results in epithelial cell death. What can (-) that in order to cause BPH?
Estrogen
When stromal cells (+) IGFs, EGF, KGF that results in epithelial cell proliferation. What does that result in and what can help further that along?
BPH
– estrogen (+) as well
BPH is due to what cell proliferating?
Epithelial cells
How does Estrogen progress BPH?
(+) epithelial cell proliferation
(-) epithelial cell death
What type of malignancy commonly affects the Prostate?
Adenocarcinoma
What type of malignancy commonly affects the prostate?
Adenocarcinoma
What type of diet is a risk factor for Prostatic Adenocarcinoma?
Western diet of red meats and animal fats
What mutations can also increase the risk for Prostatic Adenocarcinoma?
MYC
MMR
HOXB13
What fusion gene is responsible for Prostatic Adenocarcinoma?
TMPRSS - ETS fusion gene
What fusion gene is responsible for Prostatic Adenocarcinoma?
TMPRSS - ETS fusion gene
The ETS gene is involved with the fusion gene that causes prostatic adenocarcinoma. What are its 2 most common forms?
ERG
ETV1
After the TMPRSS - ETS fusion gene arises, what is lost in order for prostatic adenocarcinoma to arise?
P27 loss
What zone does Prostatic Adenocarcinomas affect?
Peripheral zone
What zone does Prostatic Adenocarcinomas affect?
Peripheral zone
Prostatic Adenocarcinomas usually arise in the peripheral zone. Why is that significant?
That zone is posteriorly which allows for the cancer to be palpable on a DRE
What 3 morphologic changes are present wit Prostatic Adenocarcinoma?
- Perineural invasion
- Absence of basal cells
- Upregulation of AMACR
What 3 morphologic changes are present with Prostatic Adenocarcinomas?
- Perineural invasion
- Absence of basal cells
- Upregulation of AMACR
What may be elevated in the serum with prostatic adenocarcinoma that is NOT cancer specific?
PSA
What is PSA good for with Prostatic Adenocarcinomas?
Monitoring treatment
