Towmey Pathology Flashcards
What is the normal weight of the prostate gland?
20 grams
What are the four anatomic zones of the prostate?
Central, peripheral, transitional, periurethral
Where do most cases of BPH arise?
Transitional zone
Where do most cases of prostate carcinomas arise?
Peripheral zone
How does acute bacterial prostatitis feel on exam? Causative organisms?
Extremely tender and boggy; gram neg rods
What is the most common form of prostatitis?
Chronic abacterial - unable to identify an organism
What is the cause of benign prostatic hyperplasia?
Hormones - dihydrotestosterone
If see trabeculated bladder muscles, what is the most likely cause?
BPH, due to increased straining to push urine out
If patient is taking finasteride for 5 years and you measure his PSA, what do you need to do to evaluate the level of the PSA?
Multiply by 2.3 (5 alpha reductase inhibitors can lower PSA)
Patient complains of scrotal pain, with discrete point tenderness at superior pole of testis, what is likely causing the pain?
Torsion of the appendix testis/epididymis
Testis drain into what lymph nodes?
Para-aortic nodes
Where does the prostate lymphatics drain?
Internal inguinal nodes
Where does the distal vagina drain?
Superficial inguinal nodes
Where does the scrotum drain?
Superficial inguinal nodes
Phase I of testicular descent is controlled by what? What is the pathway?
Controlled by mullerian-inhibiting substance; transabdominal descent-descend to lower abdomen/pelvic brim
Phase 2 of testicular descent is dependent on what? What is the pathway?
Dependent on androgens; inguinoscrotal-descends through the inguinal canal into scrotum
Cryptorchid testis puts patients at increased risk for what?
Infertility and germ cell tumors
What histologic changes are seen in cryptorchid testis?
Germ cell arrest, basement membrane thickening/hyalinization, decreased germ cells in contralateral testis
What drugs is known to cause male infertility?
Diphenylhydantoin, cyclophosphamide, diethylstilbestrol exposure in utero
Epididymo-orchitis under 35 yrs old are mostly due to what?
Sexually transmitted bacterial infections
If patient presents with epididymo-orchitis due to bacterial infection and is >35 yrs old, what is the likely cause?
Association with recurrent UTIs
Caseating granuloma in the testis, is likely an infection with what?
MTb
What type of neoplasms make up the germ cell tumors?
Seminoma, embryonal carcinoma, yolk sac tumor, teratoma, choriocacrinoma
What type of neoplasms make up the sex cord stromal tumors?
Sertoli cell tumor, leydig cell tumor, granulosa cell tumor
What is the most common solid tumor in men 15-34?
Germ cell tumors
Germ cell tumors are more popular in what race?
Whites
Germ cell tumors usually have what mutation?
i(12p)
What is the most common testicular tumor?
Seminoma
During what age does the incidence of seminoma peak?
30s
What is the gross appearance of seminomas?
Homogenous white; no necrosis or hemorrhage
What is seen microscopically in a seminoma?
Very clear cytoplasm with bands through tumor that are filled with lymphocytes
During what age does an embryonal carcinoma appear?
20s-30s
What is the gross appearance of an embryonal carcinoma?
Pale, gray with regions of hemorrhage and necrosis
Microscopically, how do embryonal carcinomas appear?
Glandular/papillary appearance; sheets of undifferentiated cells with nuclear atypia
What is the most common testicular tumor in infants? Children under 3?
Yolk sac tumor most common in both age groups; teratoma is next most common
What is the gross appearance of a yolk sac tumor?
Yellow, mucinous
What is seen microscopically in a yolk sac tumor?
Schiller-duval bodies
What is elevated in the serum of a patient with yolk sac tumor?
AFP
How does choriocarcinoma spread?
Hematogenous
What serum marker is elevated in choricarcinoma?
HCG
What is seen microscopically in a choriocarcinoma?
Syncytiotrophoblastic and cytotrophoblastic elements
What is seen on gross section of a choriocarcinoma?
Hemorrhagic tissue
Testicular tumor with large multinucleated eosinophilic cytoplasm and mononuclear cells with clear cytoplasm. Grossly it appears small, hemorrhagic, and necrotic. Beta hCG is elevated. What is the likely diagnosis?
Choriocarcinoma
What testicular tumor can present with symptoms of hyperthyroidism?
Choriocarcinoma
In what population is a teratoma never benign?
Adult male
What is seen histologically in a teratoma testicular tumor?
> 1 germ layers
If a seminoma metastasizes, where are you likely to find it?
Para-aortic nodes
If a choriocarcinoma metastasizes, where are you most likely to find it?
Lung, brain, liver
Elevated AFP is seen in what testicular tumor?
Yolk sac (endodermal sinus) tumor q
What testicular tumors have elevated hCG?
Choriocarcinoma; embryonal carcinoma
Elderly male with a testicular tumor, what tumor type is high on your differential?
Lymphoma
What cancers metastasize to the testis?
Lung and prostate
