- open defect of lower abdominal wall
- incomplete resorption of anterior cloacal membrane in development
- associated with epispadias in male infants
- increased risk for bladder carcinoma (squamous carcinoma not urothelial carcinoma)
exstrophy of urinary bladder
- male with recent hx of dysuria and hematuria
- hx of repeated acute cystitis
- Echogenic item in bladder diverticulum
All of these can be caused by…..
nodular prostatic hyperplasia
Most common bug causing acute cystitis?
E. Coli
- painless hematuria
- hx of cigarette use
- all blood and urine tests normal
- usually ages 50-80, more often in men
Urothelial cell carcinoma of the bladder
- frequency of urination, pain on urination and pelvic discomfory
- hx of transurethral prostatectomy 3 months ago
- cytoscopy shows areas of hemorrhage on bladder wall
- fibrosis of lamina propria and predominance of lymphocytes
chronic cystitis
- sudden episode of painless hematuria
- papillary tumor in posterior bladder wall
- papillary fronds that are lined by urothelial epithelium
Exophytic papilloma
–1 month hx of painless hematuria
- cytoscopy shows red, velvety flat patches on bladder mucosa
- risk factors: aromatic amines, azo dyes, Schistosome haematobium, cyclophosphamide, analgesics, radiation therapy, cigarette smoking
urothelial cell carcinoma in situ
- child with scrotal swelling
- can be transilluminated
- clear serous fluid lined by mesothelium
- often associated with inguinal hernia
- patent processus vaginalis
hydrocele
- painless hematuria and flank pain
- mass in left ureter
- hydronephrosis
- requires removal of entire ureter
urothelial cell carcinoma
- young child with blood in urine
- CT shows neoplasm of bladder
- edematous, mucosal, polypoid mass (cluster of grapes)
embryonal rhabdomyosarcoma
- hx of pain and bleeding near urethral meatus
- negative urine cultures
- chronic inflammation, granulation tissue and epithelial hyperplasia on biopsy
urethral caruncle
- painless hematuria
- hx of chronic schistosomiasis
- urinalysis shows malignant cells
- cytoscopy shows mass in wall of urinary bladder
squamous cell carcinoma
- multiple raised lesions on shaft of penis
- condyloma acuminata is caused by___________
- puts the pt at increased risk for________
HPV
Carcinoma of the penis
- 20 yr old with dysuria, urgency and urethral discharge
- suppurative urethritis with redness and swelling at urethral meatus
What is the most likely etiology?
Neisseria gonorrhoeae
- acute and chronic inflammation of glans penis
- most common complication is_______
- chronic balantis
- phimosis: when orifice of prepuce is too narrow to allow retraction over the glans penis
- multiple lesions on penis for 2 months
- shiny, soft, erythematous plaques on glans and foreskin
- biopsy shows neoplastic epithelial cells connected by intercellular bridges with invasion into dermis
squamous cell carcinoma
- increased urgency to void
- can’t empty bladder completely
- enlarged nodular prostate
- biopsy shows hyperplasic prostatic glands
A possible complication is_______?
hydroureter and hydronephrosis
- intersex woman
- ambiguous female external genitals
- signs of virilization
- 46XY karyotype
Male Pseudohermaphroditism (testicular feminization syndrome)
-usually due to androgen insensitivity syndrome
- mass on young childs testicle
- solid mass that cannot be transilluminated
- biopsy shows haphazard arrangement of benign differentiated tissues (squamous and glandular epithelium, cartilage and neural tissue)
mature teratoma
- 2 year old with a mass on testicle
- neoplastic cells forming glomeruloid schiller duval bodies
- increased production of alpha-fetoprotein
yolk sac tumor
- testicular mass that cannot be transilluminated
- no tumor markers detected
- most common germ cell malignancy
- increased risk for this from cryptorchidism
Seminoma
- hx of painless testicular mass
- cannot be transilluminated (solid)
- multinucleated giant cells on biopsy
- derived from throphoblastic cells
- increase HCG levels
Choriocarcinoma
Most likely cause of a scrotal mass in a 65 year old?
malignant lymphoma
- precocious puberty in 8 year old boy
- could also present with feminization and gynecomastia
Leydig Cell tumor-may secrete androgens, estrogens or both
- fever
- testicular pain and swelling
- swollen parotid glands
Mumps virus
- 16 year old boy with breast enlargement
- Karyotype of 47 XXY
- testicular atrophy
Klinefelters syndrome
- 68 year old with elevated PSA
- tumor exhibits androgen dependent growth
- biopsy shows poorly differentiated adenocarcinoma
- Precursor lesion is______?
- aggressiveness of adenocarcinoma correlates with______?
Prostatic intraepithelial neoplasia
Gleason Score
- dysuria, frequency, urgency
- long hx of urinary tract infections with E Coli
- cytoscopy shows soft yellow plaques on mucosal surface
- biopsy shows chronic inflammatory cells with numerous macrophages with Michaelis Gutmann bodies (small, intracytoplasmic calcium rich spherical structures)
Malakoplakia
- hx of chronic cystitis
- hematuria
- mass in dome of bladder, mucinin cytoplasm of tumor cells
adenocarcinoma of the bladder
- edematous bladder with prominent central ulcer
- lymphocytes and mast cells with extensive fibrosis on biopsy
chronic interstitial cystitis
urethral meatus of lower side of penile shaft?
upper side?
lower-hypospadias
upper-epispadias
- short hx of scrotal swelling
- can be transilluminated and contains clear, milky fluid
- degenerating spermatozoa
spermatocele
- large mass on scrotum
- can be transilluminated
- composed of dilated blood vessels
- increased risk of infertility
- more common on the ______side
varicocele
Left side
- painless mass in scrotum
- cannot be transilluminated
- AFP and HCG are normal
- foci of hemorrhage and necrosis
Embryonal Carcinoma