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Pathology II Exam II > Male Genital II > Flashcards

Male Genital II Flashcards

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1
Q

What serum markers do we use to work up a testicular mass? Is there a role for biopsy?

A
  1. AFP and HCG

2. No role for biopsy

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2
Q

What are 4 differential diagnosis for a testicular mass?

A
  1. inflammation
  2. torsion
  3. Neoplasms
  4. Hydrocel etc.
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3
Q

True or false- epididymitis is only caused by sexually transmitted organisms?

A

False - E.Coli and pseudomonas are common too

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4
Q

What is torsion precipitated by? is it an emergency?

A
  1. violent movement or trauma

2. yes, must be surgically corrected within 4 hours

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5
Q

T-F– in torsion cases we may see contralateral spermatogenic abnormalities too?

A

True- autoimmune possibly

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6
Q

What type of testicular neoplasm makes up for 95% of them? What age do they peak at?

A
  1. germ cell tumors

2. 15-34

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7
Q

What are 4 main risk factors for germ cell tumors of the testes?

A
  1. cryptochidism
  2. prior testicular germ cell tumor
  3. Family history
  4. Testicular dysgenesis: ie. Klinefelter’s
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8
Q

T-F—most cases of cryptorchidism are bilateral? Where do they mostly get hung up?

A
  1. False- 25%

2. Inguinal canal

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9
Q

What does cryptorchidism look like microscopically?

A

atrophied, decreased spermatogenesis, peritubular fibrosis, INCREASED LEYDIG CELLS

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10
Q

What is the most important distinction in germ cell tumors?

A

seminomas and non-seminomatous tumors

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11
Q

What are a couple gross characteristics of seminomas?

A

homogenous nodules, gray-white/tan, without hemorrhage or necrosis

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12
Q

What does a seminoma look like microscopically?

A
  1. sheets of seminoma cells divided in lobules by fibrous septa with infiltration of lymphocytes
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13
Q

What is described by, large, round to polygonal, well defined, clear cytoplasm, round nucleus and prominent central nucleolus?

A

seminoma cell

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14
Q

What is a main gross difference of non-seminomatous germ cell tumors?

A

hemorrhagic cut surfaces, necrosis

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15
Q

What type of non-seminomatous germ cell tumor may show cartilaginous areas and cystic spaces?

A

teratoma

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16
Q

what is described by large, pleomorphic, amphiphilic cytoplasm, overlapping angry-looking nucleus, and hyper chromatic nuclei, prominent nucleoli?

A

embryonal carcinoma

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17
Q

What is the most common yolk sac tumor pattern?

A

reticular network of cuboidal/elongated cells

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18
Q

What does the yolk sac solid pattern look like?

A

sheets of polygonal cells with pale eosinophilic or clear cytoplasm

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19
Q

The endodermal sinus patter of the yolk sac tumor is characterized by what?

A

schiller-duval body (micro cyst that looks like glomeruli)

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20
Q

What stain is frequently positive in yolk sac tumor?

A

AFP- alpha fetoprotein

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21
Q

What is the overall microscopic structure of a choriocarcinoma?

A

syncytiotrophoblasts are intimately associated with cytotophoblasts within areas of extensive hemorrhage

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22
Q

What is described as large, multinucleate, abundant eosinophilic cytoplasm, vacuolated?

A

syncytiotrophoblasts

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23
Q

What are characterized by small polygonal cells, distinct borders, uniform round nuclei and sparse cytoplasm?

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A

cytotrophoblasts

24
Q

What does choriocarcinoma stain positive for?

25
Does a mature or immature teratoma more commonly have neuroepithelial tubules?
immature
26
How many testicular tumors are a mixture of two or more patterns?
32-54%
27
T-F-- any solid intratesticular mass is considered neoplastic?
True- until proven otherwise
28
Are testicular neoplasms painful?
Usually not
29
Why is LDH an important tumor marker?
correlates with tumor burden and has a prognostic value in patients with metastatic disease
30
Can testicular cancers spread to lungs and liver?
Yes-hematogenously
31
Review staging of testicular cancer
I confined in testes II confined to retroperitoneal nodes below diaphragm III outside of retroperitoneal nodes or above diaphragm
32
What is treatment and prognosis of seminoma?
Radiation and prognosis is very good
33
What are problems with the non-seminomatous carcinomas?
1. present advanced 2. metastasize earlier and hematogenously 3. some may not cause enlargement at all (choriocarcinoma)
34
Is adenocarcinoma of the prostate more commonly periurethral or posterior?
Posterior/peripheral zone BPH is periurethral/transitional zone
35
A benign prostatic gland has how many cell layers?
1. cuboidal secretory cells | 2. flattened basal cells
36
What are the 3 differentials of prostate nodules?
1. prostatitis 2. nodular hyperplasia 3. adenocarcinoma
37
Prostatitis is commonly caused by which organism? what about in chronic cases
1. E. Coli | 2. Can be same, but usually bacterial- chlamydia, mycoplasma, ureaplasma.
38
What is the incidence of BPH at 40? 60? 70?
20%, 70%, 90%
39
Is BPH a precursor of adenocarcinoma?
NO!!!!
40
What does BPH look like grossly?
multiple variable sized nodules encroaching on the urethra, making it slit like
41
What does nodular hyperplasia look like microscopically?
papillary structures with preserved 2 cell layers
42
In an enlarged prostate from hyperplasia, what are some common upstream effects?
hypertrophied bladder, hydrouretor and hydronephrosis Also, increased UTIs
43
What is the #2 cause of male cancer deaths?
Prostate- although it is the number 1 type of cancer
44
T-F- PSA is cancer specific?
False- organ specific | IT IS INCREASED IN BPH AND CANCER
45
What is the cut off for PSA?
4
46
What does a gross prostatic adenocarcinoma look like?
gritty, yellow nodule, at the peripheral zone
47
What does a microscopic adenocarcinoma look like?
1. crowded hyperchromatic nodules 2. architectural disarray 3. single layer of cuboidal cells 4. enlarged nucleus/prominent nucleoli
48
Does prostatic cancer have basal cells microscopically??
No
49
What is the gleason grading system based on?
glandular patterns and degree of differentiation
50
What are the main characteristics of gleason pattern 5?
single cells and cords, necrosis the glands are largely missing (pattern 3 had small glands, pattern 4 had long glands)
51
What stage matches the following description- confined within prostate? extraprostatic extension into fat or vesicle? invasion of adjacent structures?
T2 T3 T4
52
What is a very common metastases of prostatic cancer?
osteoblastic bone metastases- vertebrae, ribs, pelvic bones
53
What is the tx for prostatic cancer?
surgery and radiation
54
What is the treatment for metastatic prostate cancer/
orchiectomy (remove testes) or anti-androgen therapy
55
Review the criteria for active surveillance of prostate cancer-
Gleason score <50% involvement of any positive core of 12

Pathology II Exam II (16 decks)

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