Kidney and Urinary Tract Disease - Urogenital Pathology (32) Flashcards
(45 cards)
Enlargement of the prostate is also known as
Nodular hyperplasia or benign prostatic hyperplasia
Enlargement of prostate consists of
Overgrowth of epithelium and fibromuscular tissue of the transition zone and periurethral area
Symptoms of enlarged prostate are caused by
Interference with muscular sphincteric function and obstruction of urine flow through prostatic urethra
Symptoms of enlarged prostate include
Urgency, difficulty in starting urination, diminished stream size and force, increased frequency, incomplete bladder emptying and nocturia
4 distinct regions of prostate
- Central zone (CZ)
- Peripheral zone (PZ)
- Transitional zone (TZ)
- Periurethral zone
Most carcinomas arise from which part of the organ
Peripheral glands, may be palpable during digital examination of rectum
Where does nodular hyperplasia occur?
More central glands, more likely to produce urinary obstruction earlier than carcinoma
Three pathological changes in development of nodular hyperplasia
- Nodule formation
- Diffuse enlargement of the TZ and periurethal tissue
- Enlargement of nodules
Which pathological changes predominate among
Diffuse enlargement of the TZ and periurethral tissue
Which pathological changes predominate among >70yrs?
Nodule formation and enlargement
Aetiology of enlarged prostate
- Impaired cell death > accumulate of ageing cells
- Androgens cause development BPH > increase cellular proliferation and inhibit cell death
Prostatic adenocarcinoma affects which age and ethnicity group?
Over 40 years, African ancestry
Management
Surgery, radiation therapy, hormone manipulations (90% 15 yrs)
- Radical prostatectomy
- External-beam radiation therapy
- Interstitial radiation therapy (brachytherapy)
Risk factors
Age, race, family history, hormone levels (androgens), environmental influences (increased fat), inherited polymorphisms, germline mutations of tumour suppressor BRCA2
If inherit BRCA2 gene, how much more likely are you to get prostate cancer?
20 times
Grading system
Gleason
Screening
None available - limited benefits/false positives and negatives
Testicular cancer epidemiology
Highest among men of northern European ancestry
Pre-existing medical conditions associated with Testicular germ cell tumours
Prior TGCT in contralateral testicle, cryptorchidism, impaired spermatogenesis, inguinal hernia hydrocele, disorders of sex development, atopy, testicular atrophy
Seminoma common in
35-45 year olds
Teratoma common in
First and second decades of life
Seminoma clinical presentation
Testicular enlargement (with/without pain) and metastases, asymptomatic
Rare symptoms of seminoma
Gynecomastia, exophthalmos, infertility
Teratoma clinical presentation
Gradual testicular swelling with/without pain
