0430 - Male Urogenital Tract Tumours Flashcards

1
Q

What is the standard approach to a lesion or mass in any organ system?

A

Is it neoplastic or non-neoplastic?

If non-neoplastic - congenital, hamartomatous, infective, inflammatory, or a deposit?

If neoplastic, is it benign or malignant?

If malignant, is it a primary or a secondary

If a primary is it epithelial or mesenchymal?

What is the type of malignancy?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which part of the prostate is more prone to BPH, which to prostatic cancer?

A

Central zone more prone to BPH. Peripheral more prone to malignancy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the macro appearance of the normal prostate.

A

A pear-shaped organ weighing around 20 grams.

Consists of a central prostatic urethra, surrounded by glandular tissue divided into central, transitional, and periopheral prostatic tissue.

Very smooth and uniform.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe the histology of a normal prostate.

A

Consists of glands lined with fibromuscular stroma.

The glands have 2 layers - basal and luminal. Loss of basal layer defines malignancy in the prostate.

May contain corpora amylacea - calcified concretions within the glands.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some non-neoplastic prostatic conditions?

A

Infection - bacterial or tuberculous prostatitis

Inflammation - Chronic, Granulomatous, or xanthogranulomatous prostatitis.

Deposits - Calculi or amyloid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the histological appearance of chronic prostatitis

A

Like normal prostate, but much busier.

Glands still have 2 layers, but not much fibromuscular stroma left due to infiltration by leukocytes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some benign prostatic neoplasms?

A

Epithelial - Adenosis

Mesenchymal - Leiomyoma

Mixed epithelial and mesenchymal - BPH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some malignant neoplasms of the prostate?

A

Epithelial - Acinar adenocarcinoma

Mesenchymal - Leiomyosarcoma, stromal sarcoma

Mixed - Epithelial stromal sarcoma.

Also invasion from nearby organs (bladder, urethra, rectum)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Describe the micro and macro appearance of BPH. How can it be differentiated from cancer?

A

Macro - Generally in central zone, producing hyperplastic nodules which are pale on the cut surface.

Micro - Hyperplasia of both glands and stroma, but glands are still lined by 2 layers of cell (epithelial and basal)

The cells look bland. Can do an IHC stain for the basal layer - if present, it’s BPH.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the histology of prostatic adenocarcinoma

A

Glands lose their shape to become ‘bland’, and proliferate to minimise the stroma. Cells have prominent nucleoli.

MOST IMPORTANT - complete absence of the basal layer in glands.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe neoplastic squamous carcinoma of the penis.

A

Macro - large, fungating mass.

Micro - infiltrating islands of squamous cells with keratin pearls and inter-cellular bridges.

Associated with HPV. Most tumours arise from glans or inner foreskin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the normal histology of the testis

A

Consists of seminiferous tubules containing maturing spermatocytes, with Leydig cells interlying.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How can testicular tumours be classified.

A

Seminomatous or non-seminomatous.

Seminomatous tumours are radiosensitive, non-seminomatous are radio-resistant.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe a seminoma (symptoms, macro, micro)

A

Painless, unilateral, bulky testicular enlargement. Spreads via lymph nodes.

Macro - homogenous, creamy white tumour without haemorrhage or necrosis.

Micro - sheets of tightly packed cells with dark, central nuclei, prominent nucleolus and clear cytoplasm. Characteristic lymphoid infiltrate where malignant cells can mingle with the lymphocytes.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the non-seminomatous (Germ-cell) tumours of the testis

A

60% of germ cell tumours are mixed type, and all spread early, via bloodstream.

  • Teratoma (any age) - Heterogenous collection of various tissue types
  • Embryonal carcinoma (20-30yrs) - Sheets of pleomorphic cells with mitosis, necrosis, and tumour giant cells.
  • Yolk Sac tumour (<3yr old) - Solid papillary and microcystic patterns, secrete AFP.
  • Choriocarcionoma - Haemmorhagic and highly malignant. Secrete HCG.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly