urology pathology

Question 1

what are the features of lichen sclerosus?

Answer 1

chronic inflammatory condition
affects glans, coronal sulcus and/or foreskin
usually affects middle aged but can occur in children
can cause phimosis and paraphimosis
associated with SCC

Question 2

what is the clinical appearance of lichen sclerosis?

Answer 2

white patches with petechia, erosion, ulceration and pearly areas

Question 3

what are the features of a condyloma (genital wart)

Answer 3

papillomatous proliferation of squamous epithelium
occur on glans, coronal sulcus, foreskin and meatus
caused by HPV (usually 6 and 11)
transmitted via direct skin contact
soft, exophytic, papillary growth, cauliflower like

Question 4

which PeIN (penile intraepithelial neoplasia) is assocaited with HPV?

Answer 4

dedifferentiated
precursor to SCC

Question 5

what are the features of penile cancer?

Answer 5

uncommon
usually 50-60yo
SCC
HPV associated in 50% (others usually an inflammatory background)
risk factors- smoking

Question 6

how to penile SCC present?

Answer 6

painless mass, may show ulceration

Question 7

what is the function of the testes?

Answer 7

make sperm (happens in the seminiferous tubules)

Question 8

what is the function of leydig cells?

Answer 8

produce testosterone in response to LH

Question 9

what is a hydrocele?

Answer 9

accumulation of fluid around the testes between the two layers of the tunica vaginalis and mesothelial lining
cystic, smooth and fluid filled
transilluminates O/E

Question 10

what is a spermatocele?

Answer 10

cystic change within the vas of the epididymis
unknown cause and usually asymptomatic
may feel fullness

Question 11

what is a varicocele?

Answer 11

varicosities of venous plexus that drains the plexus
usually asymptomatic, ache, scrotal swelling
“bag of worms”

Question 12

what is a bell clapper deformity?

Answer 12

insertion of the tunica vaginalis is high- allows testes to be more mobile

Question 13

what are the symptoms of torsion?

Answer 13

extreme excruciating pain
no real cause
common in neonates and adolescents

Question 14

what is testicular neoplasia?

Answer 14

lump is in the testis not separate
commonish tumour (more associated with younger age groups)
generally good prognosis

Question 15

what are the features of germ cell tumours?

Answer 15

most common testicular tumour
seminoma most common version

Question 16

which testicular tumours affect older age group >50?

Answer 16

lymphoma
spermatocytic tumour
metastases from other site

Question 17

what are the features of a seminoma?

Answer 17

most common germ cell tumour
age about 40
risk factors are an undescended testes
very good prognosis
cross section looks potato-ey

Question 18

what are the features of non-seminomatous tomours?

Answer 18

less common than seminomas
rarely exist as “pure” tumours- usually mixed
aged about 30
can be very aggressive but also very chemo sensitive
have to treat early

Question 19

what are the features of a mature teratoma?

Answer 19

derived from more than 1 germ layer
all classified as malignant in the testes (usually benign in ovary)

Question 20

what is a key feature of a yolk sac tumour?

Answer 20

can produce alpha fetoprotein

Question 21

embryonal carcinoma features?

Answer 21

aggressive, associated with frequent metastases

Question 22

what are the features of a trophoblast?

Answer 22

weird looking
positive for HCG

Question 23

what is the tumour marker for most germ cell tumours?

Answer 23

LDH
level correlates with tumour cell mass