urogenital pathology Flashcards
define nodular hyperplasia or benign prostatic hyperplasia.
enlargement of the prostate due to overgrowth of the epithelium and fibromuscluar tissue of the transitional zone and periurethral area.
symptoms of benign prostatic hyperplasia
Lower urinary tract infections
Interference with muscular sphincter and by the obstruction of urine flow through pros attic urethra.
4 zones of the prostate.
normal prostate=central, transitional, peripheral and periurethral zone.
where does nodular hyperplasia originate from- (which zone of the prostate)
most centrally situated glands
this location enables it to produce early urinary obstruction.
3 pathologic changes needed to develop nodular hyperplasia
nodule formation
diffuse enlargement of transitional zone and periurethral tissue.
enlargement of the nodules.
what effect on cell proliferation do the androgens which can use benign prosaic hyperplasia have
increase cell proliferation and reduce cell death.
in what age group are prosaic cancers most prevalent
over 40s
treatment for prostatic cancer
Surgery, radiation therapy, and hormonal manipulations (antindrogenic), external beam radiation, prostatectomy.
risk factors of developing benign prostatic hyperplasia
age, race, family history, hormone levels, environmental influences.
what hormones play a key role in benign prostatic hyperplasia
androgens- maintain growth and survival of prostate cancer cells.
germline mutations in what predispose you to prostate cancer
BRAC2
what is the grading system from prostate cancers called
Gleason scoring system.
can prostate cancer be screened for
Yes- prostate specific antigen.
what is the role of the testes
produce sperm and produce androgens.
Testes are made up of what structures
tubules lined by spermatogonian (cells which differentiate and form sperm).
support cells- leydig and sertolii
what are the different types of testicular cancer
PRIMARY germ cell non-germ cell pure cell mixed cell miscellaneous haematopoietic teratomas= most common SECONDARY metastases
what pre-existing medical conditions have been associated with the development of Testicular germ cell tumours (TGCT)
o Prior TGCT in the contralateral testicle
o Cryptorchidism- undescended testes.
o Impaired spermatogenesis
o Inguinal hernia- reduced blood supply to testes
o Hydrocele- reduced blood supply to testes
o Disorders of sex development
o Prior testicular biopsy
o Atopy- genetic tendency to develop allergic diseases
o Testicular atrophy
define seminoma
cancer, cells are look like spermatogonian cells but they are malignant.
define teratoma
tumour cells have structure or cells which are not native to the place where the tumour is found.
define hamartoma
tumour cells are similar to the cells consist of structures which are e.g. breast, ovarian.
how are tumours determined in testes
age, before puberty is benign, after puberty malignant (it will metastases)
define mature teratoma
have structures which are similar to other found in the body
define immature teratoma
cells which don’t look like they come from anywhere else in the body- so invasive.
what does the blood film of a acute and chronic epididymoorchitis
ghostly outlines of infarcted seminiferous tubules, surrounded by purulent exudate containing neutrophils and other inflammatory cells.
define Idiopathic granulomatous orchitis.
testis becomes swollen, painful, and tender initially but later may have a residual mass indistinguishable from a neoplasm, prompting orchiectomy.
what do blood films of sacrodosis of the testes show
non-necrotizing granulomas involving testicular parenchyma. Special stains for fungal organisms and acid-fast bacilli are negative.
define malakoplakia of testis.
formation of soft yellow, tan, or brown nodules that replace normal testicular parenchyma.
The tubules and interstitium are extensively infiltrated by large histiocytes that have abundant eosinophilic granular cytoplasm (von Hansemann histiocytes)
Body unable to deal with infection
define Sperm Granuloma
A n exuberant foreign body giant cell reaction to extravasated sperm
which parts of the tetses does Tuberculous Orchitis happen
epididymis
define Tuberculous Orchitis
Caseating granulomatous inflammation is prominent, with fibrous thickening and enlargement of the epididymis and adjacent structures
define cryptorchidism
testicles are missing
where are undescended tetses most commonly found.
the inguinal canal or upper scrotum
2 forms of the cryptorchisdims
congential
acquired
what causes congenital cryptorchidism
anomalies in anatomic development or hormonal mechanisms involved in testicular descent.
what causes acquired cyptoorchdism
postoperative or spontaneous ascent due to various mechanisms: inability of the spermatic blood vessels to grow adequately, anomalous insertion of the gubernaculum, failure in reabsorption of the vaginal process and failure in postnatal elongation of the spermatic cord.
complications of cryptochdism
Testicular atrophy, infertility, carcinoma (TGCTs)
define hypogonadism
testicular failure
causes of primary (problem in testes) hypogonadism
undescended testis
Klinefelter syndrome, hemochromatosis (iron deposited in tissues)
mumps, orchitis, trauma, cystic fibrosis, testicular torsion (Common in young) and varicocele.
causes of secondary hypogonadism
pituitary failure (gonadotropin release controlled here), drugs (glucocorticoids, ketoconazole, chemotherapy, and opioids), obesity (due to oestrogen production from fat (dehydosetestostrone is converted to estradiol) and aging (inability to produce dehydosetestostrone)
clinical presentation of tubercles orchitis
unilateral or bilateral mass, infertility and scrotal fistula.
symptoms of sperm granuloma
history of pain and swelling of the upper pole of the epididymis, spermatic cord, and, rarely, the testis. Others have a history of trauma, epididymiditis, and orchitis.
symptoms in tuberculous orchitis
painless scrotal swelling, but other signs and symptoms include unilateral or bilateral mass, infertility, and scrotal fistula.
