Urogenital Pathology Flashcards
Symptoms of nodular hyperplasia
Urgency Difficulty starting micturation Decreased stream size Increased frequency Incomplete bladder emptying Nocturia
What is another name for nodular hyperplasia
Benign prostatic hypertrophy
What are the 4 zones in a normal prostate gland
Central
Peripheral
Transitional
Periurethral
Most carcinomas arise from which zone of the prostate gland?
Peripheral glands
Nodular hyperplasia typically occurs in which zone of the prostate gland
Central zone- causes urinary obstruction before carcinomas
Describe the growth of prostatic nodules in older men, compared with younger me
In older men they form and enlarge
In younger men (
Main cause of nodular hyperplasia
Impaired cell death- acumulation of senescent cells in the prostate
What role do androgens play in nodular hyperplasia?
They are able to increase cellular proliferation and inhibit cell death
What is the most common prostatic carcinoma?
Prostatic adenocarcinomas (95% prostatic malignancies)
In which age groups/ethnicities are prostatic adenocarcinomas most common?
> 40yrs, increase incidence in african ancestry
Risk factors for prostatic carcinomas
Age Race Androgens/hormone levels FH BRCA2 mutation
How significant are BRCA2 mutations in increasing the risk of prostatic carcinoma?
x20 increased risk
What is the scoring system for prostatic carcinomas
Gleason’s scoring system
What is the prognosis for prostatic carcinoma
Good
Risk factors for testicular germ cell tumours
Prior TGCT in contralateral testicle Crytorchidism Impaired spermatogenesis Inguinal hernia Hydrocele Disorders of sex development Prior testicular biopsy Atopy Testicular atrophy
What are the 2 types of testicular germ cell tumours?
Seminoma
Teratoma
Seminomas are common in which age group
35-45yrs
Teratomas are common in which age group?
0-20yrs
Which type of non germ cell testicular tumour presents as testicular enlargement, usually without pain, 10% metastases.
Seminoma
Which type of non germ cell testicular tumour presents as gradual testicualr swelling, usually benign pre-puberty but often malignant post puberty
Teratoma
Symptoms of seminoma
gynacomastia, exomphalmos, infertility
What hormones are secreted by seminomas?
PLAP and hCG
What is the cause of gynacomastia in seminomas
hCG
What hormones are secreted by teratomas?
Pure teratomatous tissues do not secrete tumour markers
Which type of germ cell testicular tumour is well demarcated, cream coloured, homogenous and coarsely lobulated
Seminoma (looks like semilina)
Which type of germ cell testicular tumour is well demarcated, solid, and multicystic
Teratoma
Which type of germ cell testicular tumour is made up of monotonous polygonal cells with mostly clear cytoplasm and central nuclei divided into lobules by thin bands of fibrovascular stroma
Seminoma
Which type of germ cell testicular tumour is an admixture of ectoderm and mesoderm
Teratoma
Infarcted seminiferous tubules, surrounded by purulent exudate containing neutrophils and other inflammatory cells
Acute and chronic epididymoorchitis
Swollen, painful and tender testes, may also have a mass indistinguishable to a neoplasm. No granulomas are present but interstitial and intratubular aggregation of epithelioid histiocytes, lymphocytes and plasma cells imparts a granulomatous appearance
Idiopathic granulomatous orchitis
Non-necrotizing granulomas involving testicular parenchyma
Sarcoidosis of the testis
Soft yellow, tan or brown nodules that replace normal testicular parenchyma. Tubules and interstitium are extensively infiltrated by large histiocytes with abundant eosinophilic granulomar cytoplasm.
Malakoplakia of testis
The name of the large histiocytes in malakoplakia of testis
Von hansermann histiocytes
An exuberant foreign body giant cell reaction to extravasated sperm, common after vasectomy
Sperm granuloma
Painless scrotal swelling, unilateral or bilateral mass, infertility, scrotal fistula. Caseating granulomatous inflammation is prominent, with fibrous thickening and enlargement of the epididymis and adjacent structures.
Tuberculous orchitis
Testis found in inguinal canal or upper scrotum, or abdomen
Cryptorchidism
Cryptorchidism is more common on which side?
Right
2 types of crytorchidism
Congenital and acquired
Complications of cryptorchidism
Testicular atrophy
Infertility
Carcinoma
2 types of hypogonadism
Primary and secondary
Types of primary hypogonadism
Undescended testis klinefelter syndrome Haemochromatosis Mumps Orchitis Trauma CF Testicular torsion Varicocele
Types of secondary hypogonadism
Pituitary failure
Drugs (glucocorticoids)
Obesity
Ageing
