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MBBS II ERS > L24 - Pathology of the Male genital tract > Flashcards

L24 - Pathology of the Male genital tract Flashcards

(58 cards)

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1
Q

List 3 congenital anomalies of the penis?

A

Hypospadia and Epispadia

Congenital urethral valvular obstruction

Phimosis

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2
Q

Complications of hypospadia and epispadia?

A

Predispose to urinary tract infection

interfering with normal ejaculation

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3
Q

Describe the abnormality in Congenital urethral valvular obstruction?

A

Membranous flap in the prostatic urethra

> > cause urinary obstruction

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4
Q

Describe the abnormality in Phimosis?

A

orifice of the prepuce is too small for its normal retraction

congenital or produced after inflammatory scarring

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5
Q

List some nonspecific infections of the penis and causative agents?

A

prepuce (balanitis) and glans (prosthitis)

Candida albicans, Mumps, Tuberculosis

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6
Q

Tract the ascending route of STD infection?

A

urethra > prostate > vas deferens > epididymis > testis (atrophy, scarring)

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7
Q

Complications of chronic STD?

A

Persistent inflammation > Fibrosis in:

 Urethra: fistula, stricture
 Testis: atrophy, scarring

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8
Q

Systemic complication of STDs?

A

endocarditis (valves), arthritis

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9
Q

Causative agent of Condyloma acuminata (venereal warts) ?

A

Human Papilloma Virus (HPV) types 6 and 11

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10
Q

Most common non-gonorrhea infection?

A

Chlamydial infections

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11
Q

Gross appearance of venereal warts?

A
  • single or multiple warty papillary growth on penis/scrotum
  • may spread locally to involve anogenital region
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12
Q

Histological appearance of venereal warts?

A
  • fibroblastic branching stalk covered by acanthotic squamous epithelium
  • koilocytes: perinuclear halo + smudged nuclei
  • differentiated from squamous carcinoma by the mature epithelium
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13
Q

Most common malignant tumour of penis? Age of incidence?

A

Squamous cell carcinoma

50-70 years

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14
Q

Etiology of penile scc?

A
  • Not Circumcised
  • Poor hygiene and smegma
  • HPV infection
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15
Q

Gross, histological appearance of penile SCC and route of spread?

A

Gross: exophytic ulcerated growth or nodular plaques

Histology: squamous cell carcinoma

Course: regional lymph nodes metastasis

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16
Q

Gross appearance of penile carcinoma in-situ and disease progression?

A

Smooth, soft red plaques OR elevated, red scaly papules on the glans and penis.

May develop into invasive squamous cell carcinoma

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17
Q

Causative agents of acute and chronic prostatitis?

A

Nonspecific infection caused by coliform bacteria, gonococci or chlamydia

May Extend from the bladder or urethra

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18
Q

List 2 inflammatory diseases of the prostate?

A

Acute and chronic prostatitis

Granulomatous prostatitis

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19
Q

Causes of granulomatous protatitis?

A

1) specific infections such as tuberculosis or syphillis

2) inflammatory reaction to inspissated secretion/ autoimmune causation

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20
Q

What is the most common prostate disease?

A

Benign prostatic hyperplasia (BPH)

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21
Q

Gross morphology of BPH?

A

distinct circumscribed grey white nodules in the periurethral zone

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22
Q

Histological appearance of BPH?

A

glandular and fibromuscular stromal proliferation

+/- infarct, infection, squamous metaplasia

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23
Q

Clinical presentation of BPH?

A

(i) asymptomatic
(ii) compression of urethra-difficulty in urination, frequency or dribbling
(iii) retention of urine > hydronephrosis, hydroureters, bladder distention and hypertrophy

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24
Q

Complications of BPH?

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A

retention of urine:

  • bladder distention and hypertrophy
  • hydroureters and hydronephrosis
  • chronic renal failure

superimposed infections-prostatitis or cystitis

25
Etiology and tumour marker for prostatic carcinoma?
Androgen causing growth of the tumor Prostatic specific antigen PSA
26
Clinical presentation of prostatic carcinoma?
Prostatism: nocturia, frequency, urgency...etc hard mass find during rectal examination/ Incidental finding during biopsy for BPH signs and symptoms of metastasis (e.g. back pain due to vertebral metastasis)
27
4 clinical uses for tumour marker PSA?
· Screening of occult prostate cancer · Detection of recurrence · Find distant metastasis · Identify primary metastatic tumour/ ectopic tumour
28
Gross and histological appearance of Prostatic carcinoma?
Gross = yellowish, hard, gritty tissue Histological = · Adenocarcinoma with acini
29
Mode of prostatic carcinoma spread?
· Local -causing prostatic urethra obstruction and infiltrate adjacent tissue · Lymphatics -presacral in pelvis, iliac and paraaortic lymph nodes · Blood/ Retrograde venous -vertebra, osteoblastic, widespread metastasis: Batson's Plexus to spine**
30
Treatment for prostatic carcinoma?
surgery +/- hormonal therapy
31
Describe one congenital anomaly of the testes and epididymis?
Cryptorchidism(undescended testes) failure of the intraabdominal testes to descend into the scrotal sac
32
Complications of Cryptorchidism?
inguinal hernia, trauma, testicular atrophy (at and after puberty), increased incidence of testicular tumor Infetility (if bilateral)
33
List 2 inflammatory diseases of testes and epididymis?
1) Granulomatous orchitis: due to extravasated sperm, tuberculous orchitis or testicular tumour 2) Infection: - Gonorrhea, STI and TB >> epididymitis - Syphilis >> orchitis - Mumps
34
Name and describe one vascular lesion of the testis?
Torsion = Twisting of spermatic cord interferes with venous drainage and causes engorgement and hemorrhagic infarct of the testis.
35
Describe the general origin of testicular tumours? Malignant or niot?
rare, nearly always malignant 90% of primary testicular tumours = germ cell origin; 5% from gonadal stroma; rest from other components of the testis.
36
Give examples of germ cell testicular tumours affecting newborn?
yolk sac tumour Teratoma
37
Examples of germ cell testicular tumours affecting young children? pattern of spread?
``` Choriocarcinoma = blood Teratoma = blood and lymphatic ```
38
Germ cell testicular tumours affecting young adults? pattern of spread?
``` Embryonal carcinoma (anaplastic) Lymphatic and blood ```
39
Germ cell testicular tumours affecting middle age men? Pattern of spread?
Seminoma Lymphatic
40
Germ cell testicular tumours affecting old age men?
Spermatocytic seminoma
41
2 etiologies of germ cell testicular tumours?
Cryptochidism: may involve other normal testis Strong genetic familial predisposition
42
Presentation of testicular tumours?
Testicular enlargement or pain, Distant metastasis
43
General Treatment of testicular cancer?
surgery, irradiation and chemotherapy.
44
Define the histogenesis of yolk sac tumour and choriocarcinoma of testis?
Germ cell > embryonal carcinoma in extra-embryonic tissue: cytotrophoblastic and syncytiotrophoblastic cells = choriocarcinoma Yolk sac = yolk sac tumour
45
Define the histogenesis of teratoma of testis?
Germ cell > embryonal carcinoma in embryonic tissue: More than one of mesoderm, ectoderm, endoderm elements involved >> teratoma
46
Gross morphology of testicular seminoma?
Well-demarcated tan-white homogeneous mass uniform cells in lobules separated by a fine stroma
47
Histological appearance of testicular seminoma?
large, round, central hyperchromatic nucleus with prominent nucleoli sharp cell border
48
Treatment of seminoma?
orchidectomy and postsurgical irradiation.
49
2 distinct features of yolk-sac tumour and name one 1 tumour marker?
1) distinctive perivascular structures 2) hyaline globules alpha-fetoprotein
50
Tumour marker for choriocarcinoma?
Serum and urinary Human chorionic gonadotrophin (hCG) normally Secreted by sycytiotrophoblastic cells in the placenta
51
Define the malignancy of testicular teratoma?
Differentiated mature teratomas = benign in infants and young children Mature/ immature teratoma in postpubertal male = malignant
52
Most common type of gonadal Stromal tumours in males?
Leydig cell tumours
53
Most common non-germ cell testicular tumour in men over 60?
Testicular lymphoma Mostly secondary
54
Ddx scrotal mass.
Ø Testicular tumour Ø Tumour-like conditions e.gg hydrocele and haematocele Ø Hernia Ø Orchitis Ø Torsion Ø Tumour and tumour-like conditions of spermatic cord and testicular appendages
55
List 3 prognostic factors of testicular germ cell tumours?
All about cryptorchidism * Abdominal vs inguinal * Undescended vs contralateral descended * Orchipexy vs no orchipexy (correct cryptorchidism)
56
Describe the pathohistological changes to undescended testis?
INTERSTITIAL FIBROSIS + SHRINK NO spermatogenic cells Progressive Degeneration
57
Ddx raised Alpha-fetoprotein?
• Hepatocellular carcinoma, severe cirrhosis • Germ cell tumour: testis: –yolk sac tumour –embryonal carcinoma
58
Which testicular tumours have increased hCG?
Choriocarcinoma (most) ****** Embryonal carcinoma (some) Seminoma (ST) (some)

MBBS II ERS (37 decks)

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