11: Pathology 3

Question 1

What names are given to SCC-in-situ of the penis?

Answer 1

Erythroplasia of Queryat (glans and shaft)

Bowen’s disease (everything else)

Question 2

What does SCC-in-situ of the penis look like?

Answer 2

Red, velvety plaque

Question 3

SCC occurs in men who are ___.

Answer 3

uncircumcised

Question 4

What virus is associated with SCC of the penis?

Answer 4

HPV type 16

Question 5

Is SCC of the penis common in the UK?

Answer 5

No

Question 6

What are risk factors for penile SCC?

Answer 6

Aged 20 - 35

Uncircumcised

HPV type 16

Poor hygiene

Question 7

What is a common disorder affecting men over the age of 50?

Answer 7

Benign prostatic hyperplasia (BPH)

Question 8

What causes BPH?

Answer 8

Imbalance between testosterone (decreases) and oestrogen (excess) levels

Question 9

What urinary problems does BPH cause?

Answer 9

Urine retention

Hesitancy

Slow flow

Overflow incontinence

Question 10

What group of symptoms are collectively called prostatism?

Answer 10

Hesitancy

Poor flow

Overflow incontinence

Urine retention

Question 11

Hesitancy, slow flow and incontinence are collectively called ___.

Answer 11

prostatism

Question 12

What happens to the bladder muscle in BPH?

Answer 12

Hypertrophy

Forms diverticulae (which stones can lodge in)

Question 13

What are complications caused by the obstruction in BPH?

Answer 13

Hydronephrosis

UTI

Question 14

How is BPH managed?

Answer 14

Alpha blockers

5alpha reductase inhibitors (finasteride)

Surgery

Question 15

Does BPH lead to prostate cancer?

Answer 15

Not for sure

But people who develop prostate cancer CAN have BPH

Question 16

What does BPH look like on biopsy?

Answer 16

Stromal and glandular hypertrophy

Question 17

What is the most common cancer in men in the UK?

Answer 17

Prostate cancer

Question 18

When do men tend to get prostate cancer?

Answer 18

50+

Question 19

People with a ___ history of prostate cancer are more likely to develop it.

Answer 19

family history

Question 20

Which local organs can prostate cancer spread to?

Answer 20

Urethra

Bladder

Rectum

Question 21

What is prostate cancer notorious for spreading to?

Answer 21

Bone

Question 22

What process does metastatic prostate cancer cause in bone?

Answer 22

Osteosclerosis

whereas most other cancers cause osteolysis

Question 23

What are the investigations for

a) initial
b) suspected metastatic

prostate cancer?

Answer 23

a) PR exam, blood PSA, prostate biopsy

b) CT everything, bone scans

Question 24

Does an elevated PSA mean prostate cancer?

Answer 24

No, lots of other reasons

But if gradually, consistently increasing then probably prostate cancer

Question 25

Which a) drugs b) surgery are used to treat prostate cancer?

Answer 25

**a) LHRH agonists, anti-androgen** **b) Prostatectomy**

Question 26

What is the **prognosis** of testicular cancer?

Answer 26

**Very good**

Question 27

What is a big risk factor for **testicular cancer**?

Answer 27

**Undescended testes**

Question 28

Is testicular cancer **painful**?

Answer 28

**No, usually presents as PAINLESS TESTICULAR LUMP**

Question 29

What is an endocrine symptom associated with testicular cancer?

Answer 29

**Gynaechomastia**

Question 30

What are two **germ cell tumours** of the testicle?

Answer 30

**Seminoma** **Teratoma**

Question 31

Which **germ cell** **tumour** of the testicle is most common?

Answer 31

**Seminoma**

Question 32

What do **seminomas** look like on biopsy?

Answer 32

**Solid, homogenous, pale** | (like a potato)

Question 33

What cells are present in the interstitium of **seminomas**?

Answer 33

**Lymphocytes**

Question 34

Which treatment are **seminomas** sensitive to?

Answer 34

**Radiotherapy**

Question 35

What type of germ cell tumour makes up **1/3rd** of testicular cancers?

Answer 35

**Teratoma** group of different cancers

Question 36

What is the appearance of **teratomas** on biopsy?

Answer 36

**Solid** **Cystic** **Haemorrhage** **Necrosis**

Question 37

Why are **germ cell tumours** given that name?

Answer 37

**Contain cells derived from all three germ layers**

Question 38

What are markers of testicular cancer?

Answer 38

**AFP** **hCG** **LDH**

Question 39

Apart from being markers of testicular cancer, what are **AFP** and **hCG** also notable for?

Answer 39

**AFP** - marker for hepatocellular carcinoma **hCG** - pregnancy test

Question 40

**Seminomas** and **teratomas** both produce ___ and \_\_\_. **Seminomas** don't produce \_\_\_.

Answer 40

**both produce hCG** and **LDH** ## Footnote **seminomas don't produce AFP**