Urogenital Pathology Flashcards
What is BPH?
Benign prostatic hyperplasia - enlargement of epithelial and fibromuscular tissue in prostate
Where does BPH usually occur?
TRANSITION ZONE and PERIURETHRAL ZONE - more central so compresses urethra
What are the symptoms of BPH? (LOWER URINARY TRACT SYMPTOMS)
- Increased urgency/frequency
- Problems starting urination/emptying bladder
- Nocturia
- Diminished stream size and force (‘not hitting wall’)
Where do most carcinomas of the prostate arise?
Peripheral zone - symptoms of BPH do not arise until very advanced
What is the pathogenesis of BPH? What is predominant in older men? (*)
Nodule formation*
Enlargement of transitional and periurethral zone
Enlargement of nodules*
What is the cause of BPH?
Impaired cell death resulting accumulation of senescent (old) cells in prostate
Hormone imbalance e,g, testosterone (DHT)
What is the main type of prostate cancer?
Prostatic adenocarcinoma
What is the treat for prostatic adenocarcinoma?
- Surgery - radical prostatectomy
- Radiotherapy
- Hormonal manipulations
What are the risk factors for prostatic cancer?
Age, race, family history, environmental (increased consumption of fats)
Androgen exposure - reduced androgen exposure (with castration/anti-androgens) is associated with disease regression
BRCA2
What grading system is used for prostatic carcinoma?
Gleason grade
TMN stage
Why is there no screening programme for prostatic cancer?
Prostatic specific antigen - associated with false negatives/positives
Complications of treatment e.g. importance, incontinence
Unnecessary treatments/limited benefits
What are the two functions of the testes?
Sperm production
Androgen production
What are the major aetiological causes of germ cell tumours?
- Prior germ cell tumour in contralateral testicle
- Cryptochordism (absence of testicle(s) in scrotum - e.g undescended)
- Inguinal hernia/hydrocele (anything impairing blood flow to testicle)
- Disorder spermatogenesis
- Testicular atrophy
What age group do seminomas most likely effect?
35-45 yr olds (rare >50 yrs)
What are the clinical presentations of seminomas?
Pain Testicular enlargement Asymptomatic Metastases Infertility Gynecomastia - male breasts
What serum markers are associated with seminoma?
PLAP
hCG - cause of gynecomastia
When do teratomas most commonly arise?
10-20yrs old
If the patient is pre-pubescent, what is a mature teratoma considered?
Benign
If the patient is post-pubescent, what is a mature teratoma considered
Malignant
What serum tumour markers do teratomas secrete?
none
What is the definition of orchitis?
Any inflammatory condition of the testes
What are the clinical features and causes for epididymoorchitis?
Infective inflammation of epididymus
Fever, malaise, pain, warm, enlarged
Neutrophil invasion and inflammation
UTI (non-specific)/gonococcal infection
What are the clinical features of an idiopathic granulomatous orchitis?
Older people (idiopathic = unknown cause)
Symptoms of UTI, trauma or flu-like lines
Testis = swollen painful and tender
What is sarcoidosis of the tests?
Granulomas in the testes
