XVIII - The Male Genital System

Question 1

An abnormal opening of the urethra along the ventral aspect of the penis.

Answer 1

Hypospadias(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 687

Question 2

An abnormal opening of the urethra along the dorsal aspect of the penis.

Answer 2

Epispadias(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 687

Question 3

A congenital malformation of the bladder associated with epispadias.

Answer 3

Bladder extrophy(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 688

Question 4

A condition in which the prepuce cannot be retracted easily over the glans penis

Answer 4

Phimosis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 688

Question 5

Appears grossly as a solitary, plaquelike lesion on the shaft of the penis. Histologic examination reveals morphologically malignant cells throughout the epidermis with no invasion of the underlying stroma. Has potential for malignant transformation.

Answer 5

Bowen disease(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 688

Question 6

Bowen disease which presents as an erythematous patch on the glans penis.

Answer 6

Erythroplasia of Queyrat(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 688

Question 7

Occurs in young, sexually active males, histologically identical to Bowen disease. Presents with multiple reddish brown papules on the glans and is most often transient, with rare progression to carcinoma in immunocompetent patients.

Answer 7

Bowenoid papulosis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 688

Question 8

Appears as a gray, crusted, papular lesion, most commonly on the glans penis or prepuce, which infiltrates the underlying connective tissue to produce an indurated, ulcerated lesion with irregular margins.

Answer 8

Squamous cell carcinoma of the penis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 689

Question 9

A variant of squamous cell carcinoma characterized by a papillary architecture, less striking cytologic atypia, and rounded, pushing deep margins.

Answer 9

Verrucous carcinoma (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 689

Question 10

Most common cause of scrotal enlargement, which is an accumulation of serous fluid within the tunica vaginalis usually secondary to infection or malignancy.

Answer 10

Hydrocele(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 689

Question 11

Represents failure of testicular descent into the scrotum which involves the right testis more commonly than the left. Causes increased risk of sterility and development of testicular cancer.

Answer 11

Cryptorchidism(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 690

Question 12

Most important cause of firm, painless enlargement of the testis.

Answer 12

Testicular neoplasms(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 690

Question 13

Composed of sheets of large, uniform cells with distinct cell borders, clear, glycogen-rich cytoplasm, and round nuclei with conspicuous nucleoli. The cells are often arrayed in small lobules with intervening fibrous septa.

Answer 13

Seminomas(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 691

Question 14

These tumors contain a mixture of medium-sized cells, large uninucleate or multinucleate tumor cells, and small cells with round nuclei that are reminiscent of secondary spermatocytes.

Answer 14

Spermatocytic seminoma(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 691

Question 15

Ill-defined, invasive masses containing foci of hemorrhage and necrosis. Poorly differentiated, pleomorphic cells in cords, sheets, or papillary formation; most contain some yolk sac and choriocarcinoma cells

Answer 15

Embryonal carcinoma of the testis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692

Question 16

Most common primary testicular neoplasm in children younger than 3 years of age.

Answer 16

Yolk sac tumors/endodermal sinus tumors(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692

Question 17

Low cuboidal to columnar epithelial cells forming microcysts, sheets, glands, and papillae, often associated with eosinophilic hyaline globules. (+) Schiller-Duval bodies

Answer 17

Yolk sac tumors/endodermal sinus tumors(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692

Question 18

Structures resembling primitive glomeruli, seen in yolk sac tumors.

Answer 18

Schiller-Duval bodies(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692

Question 19

Cytotrophoblast and syncytiotrophoblast without villus formation

Answer 19

Choriocarcinomas (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692

Question 20

Tissues from all three germ-cell layers with varying degrees of differentiation

Answer 20

Teratomas(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692

Question 21

Teratoma which contain fully differentiated tissues from one or more germ cell layers (e.g., neural tissue, cartilage, adipose tissue, bone, epithelium) in a haphazard array.

Answer 21

Mature teratomas (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692

Question 22

Teratoma which contain immature somatic elements reminiscent of those in developing fetal tissue.

Answer 22

Immature teratomas(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 692

Question 23

Characterized by the presence of an acute, neutrophilic inflammatory infiltrate, congestion, and stromal edema of the prostate.

Answer 23

Acute prostatitis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 695

Question 24

Characterized by variable amount of lymphoid infiltrate, evidence of glandular injury, and, frequently, concomitant acute inflammatory changes of the prostate.

Answer 24

Chronic prostatitis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 695

Question 25

Nodular hyperplasia is usually more pronounced in what part/s of the prostate?

Answer 25

Inner (central and transitional) region of the prostate(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 696

Question 26

Composed of proliferating prostatic glandular elements and fibromuscular stroma. The glandular lumina often contain inspissated, proteinaceous secretory material, termed corpora amylacea.

Answer 26

Nodular Hyperplasia of the Prostate (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 697

Question 27

Major hormonal stimulus for proliferation in nodular hyperplasia of the prostate.

Answer 27

DHT (Dihydrotestosterone)(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 698

Question 28

Most common area of the prostate affected by prostatic carcinoma.

Answer 28

Outer (peripheral) glands (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 698

Question 29

Concentration of this biochemical marker is of great value in monitoring patients after treatment for prostate cancer.

Answer 29

Prostate specific antigen (PSA)(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 700

Question 30

A commonly used method for grading prostatic carcinoma, which is based on features such as the degree of glandular differentiation, the architecture of the neoplastic glands, nuclear anaplasia, and mitotic activity.

Answer 30

Gleason system(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 700

Question 31

A chronic venereal infection caused by the spirochete Treponema pallidum, whose fundamental microscopic lesion is a proliferative endarteritis and an accompanying inflammatory infiltrate rich in plasma cells.

Answer 31

Syphilis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 702

Question 32

An irregular, firm mass of necrotic tissue surrounded by resilient connective tissue. Contains a central zone of coagulation necrosis surrounded by a mixed inflammatory infiltrate composed of lymphocytes, plasma cells, epithelioid cells, giant cells, and a peripheral zone of dense fibrous tissue. Seen in tertiary syphilis.

Answer 32

Gumma(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 702

Question 33

This stage of syphilis is characterized by the presence of an indurated chancre at the site of initial inoculation, associated with painless regional lymphadenopathy.

Answer 33

Primary Syphilis (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 702

Question 34

Both nontreponemal and antitreponemal antibody tests are strongly positive in virtually all cases of this stage of syphilis.

Answer 34

Secondary syphilis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 702

Question 35

In males this is manifested most often as a purulent urethral discharge, associated with an edematous, congested urethral meatus. Gram stain of urethral discharge, demonstrates the characteristic gram-negative, intracellular diplococci.

Answer 35

Gonorrhea (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 705

Question 36

A gram-negative intracellular bacterium that causes a disease that is clinically indistinguishable from gonorrhea in both men and in women.

Answer 36

Chlamydia trachomatis(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 707

Question 37

C. trachomatis infection causing a triad of reactive arthritis, conjunctivitis and generalized mucocutaneous lesions.

Answer 37

Reiter syndrome(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 707

Question 38

This STD is a chronic, ulcerative disease caused by certain strains of C. trachomatis, which presents with nonspecific urethritis, papular or ulcerative lesions involving the lower genitalia, regional adenopathy, or an anorectal syndrome.

Answer 38

Lymphogranuloma venereum (LGV) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 707

Question 39

This STD is an acute, ulcerative infection caused by Haemophilus ducreyi, a small, gram-negative coccobacillus. The lesion is an irregular ulcer, whose base is covered by a shaggy, yellow-gray exudate. Regional lymph nodes are enlarged and tender.

Answer 39

Chancroid (Soft Chancre) (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 707

Question 40

A chronic inflammatory disease caused by Calymmatobacterium granulomatis. The organisms are demonstrable in Giemsa-stained smears of the exudate as minute coccobacilli within vacuoles in macrophages (Donovan bodies). Regional lymph nodes are typically spared.

Answer 40

Granuloma Inguinale (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 708

Question 41

The initial lesions of this infection are painful, erythematous vesicles on the mucosa or skin of the lower genitalia and adjacent extra-genital sites. Cowdry type A inclusions appear as light purple, homogeneous intranuclear structures surrounded by a clear halo.

Answer 41

HSV 2(TOPNOTCH)Robbins Basic Pathology, 8th ed., p 708

Question 42

Caused by HPV types 6 and 11. Lesions vary from small, sessile lesions to large, papillary proliferations measuring several centimeters in diameter.

Answer 42

Condylomata acuminata (TOPNOTCH)Robbins Basic Pathology, 8th ed., p 709

Question 43

What is the most common cause of hydronephrosis in infants and children?

Answer 43

Ureteropelvic junction obstruction (TOPNOTCH)

Question 44

Fiery red appearance of the cervix is associated with what type of infection?

Answer 44

Strawberry cervix is associated with T. vaginalis infection (TOPNOTCH)

Question 45

Approximately 70% of prostate carcinoma will arise in what zone of the gland?

Answer 45

Peripheral zone ( posterior location) (TOPNOTCH)

Question 46

What is the best known grading system for Prostate Carcinoma?

Answer 46

Gleason System (TOPNOTCH)

Question 47

Morphology: hallmark is nodularity due to glandular proliferation or dilation and to fibrous or muscular proliferation of the stroma

Answer 47

BPH (TOPNOTCH)

Question 48

Nodular hyperplasia of the prostate originates almost exclusively in what zone of the gland?

Answer 48

Transition zone (TOPNOTCH)

Question 49

Morphology: appear as minute, disseminated abscesses or diffuse edema, congestion, and boggy suppuration of the entire prostate

Answer 49

Acute prostatitis (TOPNOTCH)

Question 50

Morphology: aggregation of numerous lymphocytes, plasma cells, and macrophages as well as neutrophils within the prostatic substance

Answer 50

Chronic prostatitis (TOPNOTCH)

Question 51

Morphology: tumor cells are arranged in distinctive trabeculae with a tendency to form cordlike structures resembling immature seminiferous tubules

Answer 51

Sertoli Cell Tumors or Androblastoma (TOPNOTCH)

Question 52

Morphology: rod shaped crystalloids of Reinke

Answer 52

Leydig/Interstitial Cell Tumors (TOPNOTCH)

Question 53

What is the most common form of testicular neoplasm in men over the age of 60?

Answer 53

Testicular Lymphoma (TOPNOTCH)

Question 54

Morphology: disorganized collection of lands, cartilage, smooth muscle, and immature stroma

Answer 54

Teratoma of the testes (TOPNOTCH)

Question 55

What do you call the structures resembling endodermal sinuses that may be seen in Yolk Sac Tumor?

Answer 55

Schiller Duval Bodies (TOPNOTCH)

Question 56

Morphology: reveals large cells with distinct cell borders, pale nuclei, clear or watery appearing cytoplasm, prominent nucleoli, and a sparse lymphocytic infiltrate

Answer 56

Seminona (TOPNOTCH)

Question 57

Within how many hours should the testes be explored surgically and untwisted manually so the testes will be viable after a testicular torsion?

Answer 57

(TOPNOTCH) Within 6 hours

Question 58

Morphology: clear vacuolization of the prickle cells

Answer 58

Condylomata acuminatum (koilocytosis) (TOPNOTCH)

Question 59

What HPV DNA type is found in approximately 80% of Bowen Disease and bowenoid papulosis?

Answer 59

HPV Type 16 (TOPNOTCH)

Question 60

What type of bladder cancer is associated with long standing schistosomiasis?

Answer 60

Squamous cell carcinoma (TOPNOTCH)

Question 61

In bladder carcinoma, the major decrease in survival is associated with tumor invading what layer of the bladder?

Answer 61

Muscularis propria (detrussor muscle) (TOPNOTCH)