Reproductive Flashcards
What do the dorsal and ventral triangular hypo echoic regions of the prostate correspond to histologically?
They correspond to glandular tissue
Glandular tissue is also located in the periphery of the prostate, creating a thin hypoechoic rim around the circumference of the prostate
What does the hyperechoic regions within the prostate correspond to?
Collagenous tissue
What does the prostate of sexually immature dogs looks like and why?
It looks diffusely hyperechoic, reflecting lack of glandular tissue development and a preponderance of collagen fibers.
Describe how the position of the prostate changes with time and explain why.
The prostate is reported to be within the abdominal cavity at birth until ~ 2 months of age, when it moves to the pelvic cavity, subsequent to breakdown of urachal remnant.
It enlarges at sexual maturity secondary to hormone influences, becoming progressively more intraabdominal in location.
What is sonographic appearance of benign prostatic hyperplasia?
May be subtle inhomogeneity of the parenchyma without obvious enlargement.
Often the prostate does enlarge. The enlargement may be symmetric or asymmetric, smooth or nodular, distorting the margin of the gland. Diffuse enlargement may cause loss of the normal bilobed appearance of the prostate.
The margins of the gland should be seen and differentiated from the surrounding tissues.
The echogenicity of the gland varies. It may be diffusely homogeneous and hypoechoic to hyperechoic, but some degree of inhomogeneity is noted in most cases.
Scattered hyperechoic foci, thought to be secondary to increased vascularity and fibrosis, may be present.
Intraparenchymal cysts of varying size and number can be present; these probably represent dilated acini and ducts secondary to hyperplasia.
It should not disrupt the capsule of the prostate and there should be medial iliac lymphadenopathy.
What is the sonographic appearance of prostatitis?
It can be similar to benign nodular hyperplasia.
Definitive diagnosis must be made by aspiration for culture and sensitivity analysis and by biopsy.
What is the sonographic appearance of prostatic neoplasia?
Typically, the gland is enlarged, is irregular in shape, and has a heteroge- neous echo texture. Hyperechoic foci may be dispersed throughout the parenchyma or be confined to focal areas.
Differentiating prostatitis from prostatic carcinoma can be difficult. The following criteria of malignancy can be used:
- mineralization in prostatic disease in neutered dogs is an ominous sign
- extension of pathologic changes to the urethra or neck of the urinary bladder
- hydroureter and hydronephrosis secondary to prostatic tumor invasion of the urinary bladder trigone
- regional lymph node enlargement
- disruption of the capsule with extension to the surrounding tissues are ominous signs indicating neoplasia.
*Prostatic mineralization in neutered dogs had a 100% positive predictive value for malignancy, whereas intact dogs without prostatic mineralization were unlikely to have prostatic neoplasia.
What is the sonographic appearance of paraprostatic cysts?
The ultrasound evaluation of paraprostatic cysts typically reveals an anechoic, fluid-filled structure. Wall thickness can vary.
The contents of the cyst may have focal echogenicities, perhaps demonstrating a swirl- ing movement when agitated with transducer pressure. Sedimentation of the contents can occasionally be demonstrated.
Paraprostatic cysts can appear as predominantly solid structures, with complex, multilocular echo formation. Infection by gas-forming bacteria can lead to hyperechoic foci within the cyst.
Concurrent prostate disease may be present.
Bilateral prostatic cysts have been reported in association with a Sertoli cell tumor of a retained testis
What is histologic appearance of Interstitial (Leydig cell) tumors?
Interstitial cell tumors:
- Composed of small nodules that may be singular or become confluent to form large nodular masses; they are poorly encapsulated and are yellowish, soft, and greasy on cut surface.
- They may be bilateral and associated with hormone abnormalities.
**Cannot be distinguished sonographically.
What is histologic appearance of Sertoli tumors?
Sertoli cell tumors:
- Often cause testicular enlargement and are associated with feminizing syndrome and bone marrow sup- pression due to high estrogen production.
- The opposite (normal) testicle will atrophy.
**Cannot be distinguished sonographically.
What is histologic appearance of Seminomas?
Seminomas:
- Are often large, solitary, unilateral lesions, with internal necrosis and hemorrhage. The cut surface is white to gray and may exude a milky fluid.
- Seminomas are not associated with hormone production.
**Cannot be distinguished sonographically.
What is the sonographic appearance of orchitis?
Diffuse, patchy, hypoechoic parenchymal pattern, usually with testicular and epididymal enlargement.
Orchitis can appear similar to neoplasia, although extratesticular fluid and epididymal enlargement may more commonly be associated with infection.
How does the ovary appear during anestrus and proestrus?
During anestrus and early proestrus, they are small, usually oval to bean shaped, and have a homogeneous echogenicity similar to that of the renal cortex, some- times with indistinct margins.
Doppler evaluation of dog ovaries during estrus has been reported. It was shown that intraovarian perfusion gradually increased during proestrus.
Describe the sonographic changes that occur with follicular development.
Sonographic evaluation of canine follicular maturation and ovulation has been well studied. Anechoic preovulatory follicular cysts may initially be identified at day 1 to day 7 of proestrus. Multiple small anechoic follicles are seen, enlarging with time until ovulation occurs, at which time 3 to 4 follicles are typically seen on each ovary. They can measure up to 1 cm in dogs and up to 3cm in cats.
How can ovulation be detected monographically?
In the dog, ovulation may be detected sonographically when there is a decrease in the number and size of follicles from one day to the next.
