HD2 Histology: Male Reproductive Pathology

Question 1

Label A-C

Answer 1

A: Semineferous tubules
B: Tunica albuginea
C: Epididymis

Question 2

Answer 2

Question 3

Name this region of the testis [1]

Answer 3

Rete testis

Question 4

What is the layer called that surrounds the testis? [1]

Answer 4

tunica albuginea

Question 5

Name the two stages of spermatogenesis [2]

Answer 5

Spermatogenesis (Spermatogenesis is the process by which an undifferentiated spermatogonium develops into a spermatid)
Spermiogenesis (Spermiogenesis is the process by which a spermatid matures into a spermatozoan)

Question 6

Describe the process of spermatogenesis [5]

Answer 6

Spermatogenesis:
* Division of spermatognia into more spermatogonia and primary spermatocytes via meiosis
* Spermatogonia remain in the basal compartment
* Primary spermatocytes migrate away from the basement membrane and cross in the adjuminal comparment towards the lumen of the ST
* Primary spermatocytes then enter meiosis (prolonged prophase) - which faciliates the exchange of genetic material between homologous chromosomes
* First division creates secondary spermatocytes with 23 pairs of chromosomes
* Secondary spermatocytes divide into haploid spermatids

Question 7

What is the final product of spermatogenesis? [1]

Answer 7

Haploid spermatid

Question 8

Describe the processes that occur in spemiogenesis [4]

Answer 8

Cellular changes occur in the spermatid:
* Development of acrosome
* Development of flagellum
* Mitochondria develop around flagellum
* Bulk of cytoplasm is removed

Question 9

Describe the processes that occur in spemiogenesis [4]

Answer 9

Cellular changes occur in the spermatid:
* Development of acrosome
* Development of flagellum
* Mitochondria develop around flagellum
* Bulk of cytoplasm is removed

Question 10

What does the sperm acrosome contain [1] and what is their function [1]

Answer 10

Contents: hydrolytic enzymes
Role: help the sperm penetrate the egg’s coats

Question 11

Where are sertoli cells located? [1]

Answer 11

germinal epithelium of the seminiferous tubules.

Question 12

Describe the structure / how would you recognise sertoli cells? [2]

Answer 12

Nuclei is oval, intense nucleolus and large nucleus
Extend from the basement membrane to the lumen of seminiferous tubules
Have abundant cytoplasm

Question 13

Describe the role of sertoli cells:

• Structurally [1]
• Which molecules does it produce? [2]

Answer 13

• synthesize androgen-binding protein: keeps testosterone levels high in the ST
• Structural and chemical support to the developing spermatogonia, spermatocytes and spermatids: forms barrier stopping sperm
• produce inhibin: controls amount of FSH produced

Question 14

What is the role of Leydig cells? [1]
Name of structre often found inside them? [1]

Answer 14

• Produce testosterone: binds to androgen binding protein in the Sertoli cells
• Causes the the growth and maintenance of cells of the germinal epithelium and the development of secondary sex characteristics
• Often have cytoplasmic crystals of Reinke

Question 15

Explain the role of the blood-testis barrier? [2]

Answer 15

Creates an Immunological Barrier:

This is necessary to avoid the production of anti-sperm antibodies and autoimmune disease, which leads to male infertility

Question 16

Describe the appearance of prepuberty testis? [3]

Answer 16

• the seminiferous tubules contain mostly Sertoli cells (oval nuclei)
• A few differentiated Leydig cells
• Most of the interstitial tissue between tubules are fibroblasts

Question 17

Why is there no testosterone produced in prepuberty testis? [1]

Answer 17

No FSH produced so no testosterone produced

Question 18

What are the cell types of rete testis? [1]

Answer 18

ciliated cuboidal epithelial

Question 19

Where in the testis do sperm become mobile? [1]

Answer 19

Epididymis

Question 20

Describe the structure of the epididymis [2]

Answer 20

• pseudostratified epithelium w/ non-motile stereocilia
• contain lots of spermatozoa in the lumen

Question 21

What is the function of the non-motile stereocilia on the epididymis? [1]

Answer 21

absorb much of the excess fluid containing the spermatozoa

Question 22

Describe the structure of the ducuts / vas deferens

Answer 22

• Muscular wall comprised of: Inner longitudinal, middle circular, and outer longitudinal
• Pseudostratified cells bearing stereocilia

Question 23

How can you distinguish between a slide that is the seminiferous tubule compared to the epididymis? [1]

Answer 23

seminiferous tubule: few sperm in lumen

epididymis: lots of sperm in lumen

Question 24

Seminal vesicles are glandular sacs that produce a secretion that composes 80% of the seminal fluid. Name three productst that are in the secretion produced by the seminal vesicles

Answer 24

Contains fructose, fibrinogen, and prostaglandins (energy for sperm; keeps seminal fluid liquid)

Question 25

Describe the structure of the seminal vesicles [3]

Answer 25

- Appear **honeycombed**: thin **highly branched folds of mucosa** - lined by a **pseudostratified columnar epithelium** - Note the layer of **smooth muscle** surrounding the **saccular dilation** of the gland (helps to expel fluid)

Question 26

The prostate produces a secretory product containing what? [2]

Answer 26

**Citric acid** and **proteolytic** **enzymes** that prevent coagulation of semen and break down female mucus

Question 27

What is the structure of the cells in the prostate? [1] How can you recognise that a slide comes from the prostate? [1]

Answer 27

**Columnar** Contain **prostatic concretions** – protein aggregations that accumulate

Question 28

What is the structure of the cells in the prostate? [1] How can you recognise that a slide comes from the prostate? [1]

Answer 28

**Columnar** Contain **prostatic concretions** – protein aggregations that accumulate

Question 29

The male urethra is lined by what type of cell? [1] How does this change when it reaches the opening? [1]

Answer 29

Urethra is lined with **transitional epithelium** But at its opening changes to a stratified squamous epithelium

Question 30

How would atrophic testis appear? [1] Which cell types are present? [2]

Answer 30

**Looks like pre-pubertal seminiferous tubule** * Seminiferous tubules contain **Sertoli** **cells**, but **none of the characteristic cells of spermatogenesis** * Abundant Leydig cells remain in the interstitium

Question 31

In which condition would you see atrophic testis? [1]

Answer 31

Atrophic testes occur in **cryptorchidism**, when testis fail to descend into the scrotum

Question 32

How would you expect the levels of testosterone to compare to a health male individual? [1]

Answer 32

Because the number of Leydig cells does not change, the **levels of testosterone should be similar to a healthy male**

Question 33

Nodular hyperplasia of the prostate: which part of the prostate does it occur in? [1]

Answer 33

Transitional zone has proliferation and hypertrophy

Question 34

Adenocarcinoma prostate: Occurs in which zone of the prostate? [1] How does is it present histopathologically/ [1]

Answer 34

peripheral zone w/ adenocarnioma Note the malignant glands are generally smaller than benign glands | Benign: L; Malignant: R

Question 35

Explain the pathophysiology of testicular torsion

Answer 35

**Twisting of spermatic cord:** * Venous compromise * Turns to arterial occlusion * Ischemia

Question 36

Treatment of testicular torsion? [3]

Answer 36

Treatment * **Detorsion** * **Orchidopexy** (surgical procedure that moves an undescended testicle into the scrotum). Plus contralateral side check * **Orchiectomy** (a surgical procedure to remove one or both testicles) 42% during surgical evaluation

Question 37

What are the two types of testicular cancer & where do they originate? [2] Which is more common? [1] Which is more likely to metastasise? [1]

Answer 37

**Seminomas**: * Originate in germinal epithelium of seminiferous tubules (**germ cells**) * More common **Non-seminmomas** * Yolk sac, embryonal cell, choriocarcinoma and teratomas * More likely to metastasise

Question 38

Which part of the testis changes during testicular cancer and how does it present? [1]

Answer 38

**Seminiferous tubule** becomes full of **proliferating spermatogonia**

Question 39

Which part of the testis changes during testicular cancer and how does it present? [1]

Answer 39

**Seminiferous tubule** becomes full of **proliferating spermatogonia **

Question 40

Treatment for testicualr cancer?

Answer 40

* **Surgery** (radical orchiectomy) for primary * **Surveillance protocol**s used for stage 1 disease * **Radiation** (very radiosensitive tumour) and **chemotherapy** (platinum based) used in **higher stage disease** * **Retroperitoneal** **lymph** b dissection used for residual **post chemotherapy disease**

Question 41

Label A-F

Answer 41

Question 42

Label A-C

Answer 42

Question 43

What is wrong with this testis slide? [1]

Answer 43

Nothing: prepubertal

Question 44

Answer 44

Question 45

Which part of the male reproductive tract is this? [1]

Answer 45

epididymis

Question 46

Which part of the male reproductive tract is this? [1]

Answer 46

Vas deferens

Question 47

Which part of the male reproductive tract is this? [1]

Answer 47

Seminal vesicle

Question 48

Which part of the male reproductive tract does this histology slide depict? [1] Seminal vesicle Prostate Vas deferens Epididymus Seminiferous tubule

Answer 48

Which part of the male reproductive tract does this histology slide depict? [1] Seminal vesicle Prostate **Vas deferens** Epididymus Seminiferous tubule

Question 49

Name and descirbe the role of A [2]

Answer 49

Leydig cell; produces testosterone

Question 50

Identify A, B, C, and D in this image of the germinal epithelium.

Answer 50

A = **Leydig cell,** B = **spermatozoa**, C = **primary spermatocyte**, D = **spermatogonium**

Question 51

Name this structure

Answer 51

Ductus deferens

Question 52

Which part of the male reproductive tract does this histology slide depict? [1] Seminal vesicle Prostate Vas deferens Epididymus Seminiferous tubule

Answer 52

Which part of the male reproductive tract does this histology slide depict? [1] Seminal vesicle Prostate Vas deferens **Epididymus** Seminiferous tubule

Question 53

What is the stage of the large cells with pale cytoplasm?.

Answer 53

Primary spermocytes

Question 54

Which part of the male reproductive tract does this histology slide depict? [1] Seminal vesicle Prostate Vas deferens Epididymus Seminiferous tubule

Answer 54

Which part of the male reproductive tract does this histology slide depict? [1] Seminal vesicle **Prostate** - Note the concretion in the lumen. Vas deferens Epididymus Seminiferous tubule

Question 55

Answer 55

**Sertoli cell**. They form the blood-testis barrier through intercellular connections (tight junctions). They also secrete androgen-binding protein.

Question 56

Answer 56

**Myoid cells. T**hey generate rhythmic contractions to propel spermatozoa through seminiferous tubules. They also synthesize collagen.

Question 57

Answer 57

**Leydig Cell**. It synthesizes **testosterone**. Leutenizing hormone (**LH**) stimulates it to increase production of testosterone.

Question 58

Answer 58

Sterocilia. Actin filaments provide structural support.

Question 59

Prostate:

Answer 59

Basal cell. Its presence distinguishes benign glands from adenocarcinomas.

Question 60

Answer 60

Prostatic concretion. Helps to identify the prostate.

Question 61

Which part of the male reproductive tract does this histology slide depict? [1] Seminal vesicle Prostate Vas deferens Epididymus Seminiferous tubule

Answer 61

Which part of the male reproductive tract does this histology slide depict? [1] **Seminal vesicle** Note the foldings of the mucosa, Prostate Vas deferens Epididymus Seminiferous tubule

Question 62

Answer 62