Flashcards in Male Pathophys 2- Handorff Deck (29)
Seminomas are what percent of germ cell tumors?
50%...and remember that germ cell tumors make up the VAST MAJORITY of testicular neoplasms
Microscopic appearance of Seminoma?
Fried egg. Abundant cytoplasm, distinct cell membrane
15% of seminomas produce what?
Embryonal carcinoma is what type of tumor
Mixed germ cell/ occasionally pure.
(whereas the seminoma is most commonly a pure cell tumor)
Germ cell tumors are very sensitive to?
Chemo and radiation, because they are fast growing
What is the third type of germ cell tumor we discussed?
Yolk Sac Tumor
Yolk sac tumors are almost exclusively tumors of who?
Infants and children up to 3 years of age.
In adults, yolk sac tumors are...
most commonly mixed with other germ cell tumor patterns
Main distinguishing feature of yolk sac tumor
Production of alpha fetoprotein which serves as a serum marker
Alpha fetoprotein is important for...
Evaluation of metastasis, if you remove the tumor and alpha fetoprotein doesn't decrease to zero....you have a metastasis somewhere.
Which germ cell tumor is "placenta like"?
choriocarcinoma...malignant tumor of syncytiotrophoblasts and cytotrophoblasts.
choriocarcinomas are highly aggressive.
Choriocarcinomas produce what chemical?
HCG used as a tumor marker. Remember, hCG is very similar to LH, FSH, and TSH so pts may present with hyperthyroidism or gynecomastia
Teratomas are commonly mixed with with other germ cell tumor types in adults. Very slow growing so they are hard to kill with radiation.
Pure teratomas are more common in who?
So what are the germ cell tumors
Teratomas, choriocarcinoma,yolk sac tumor, seminoma, embryonal carcinoma
Benign prostatic hyperplasia is more likely to occur in what part of the prostate?
Transitional and periurethral zones
Prostate cancer arises in what zones of the prostate?
Prostate glands have two types of epithelium and they are
basal and luminal.
What do the luminal cells do?
they produce seminal fluid and express prostate specific antigen
What is PSA
it is a serine protease which liquifies the seminal fluid coagulant. Basal cells do not produce PSA.
BPH is driven by
Main symptoms of BPH
bladder obstruction, urinary stasis....can be problematic as it can lead to UTIs which can cause sepsis. Therefore, BPH is not so benign as it is a cause of increased morbidity and mortality
Prostate cancer is rare under age 50
At age 70 however, at least 70% of men have at least latent prostate carcinoma.
- most tumors never progress or do so very slowly
Prostate screening recomendation
No screening for men under 40
- Individualized decisions about screening for men under 55 at higher risk (AA or positive family history)
- Greatest screening benefit ages 55-69
- Every two year screening may be preferred to annual screening
- No routine screening after age 70.
What grading system is used in prostate carcinoma
Gleason grading system....1 is the best differentiated and 6 is the worst
Patients are given scores by adding together the grades from the two most prevalent patterns.
Most common prostate carcinoma metastases
bone (osteoblastic, not lytic)
Know that the prostate is a retroperitoneal gland that surrounds the neck of the bladder