Path: Male Genital Flashcards Preview

Block 8 - Endo & Repro > Path: Male Genital > Flashcards

Flashcards in Path: Male Genital Deck (22):
1

What are the congenital anomalies of the penis?

hypospadias - urethra opens ventrally
epispadias - urethra opens dorsally

2

What is phimosis?

inflammatory disorder of penis - orifice of prepuce too small to retract over glans
due to scarring or dev anomaly
can lead to hygiene problems, accumulation of smegma --> inf, maybe carcinoma

3

What are the 3 tumors of the penis and their associations?

condyloma acuminatum - HPV 6 and 11
carcinoma in situ - HPV 16
invasive carcinoma (squamous cell) - HPV 16 and 18

4

What are the clinical variants of penile carcinoma in situ?

bowen dz: scaly, shaft and scrotum, 10% progress to invasive
erythroplasia of queyrat: red plaques, glans, 10%
bowenoid papulosis: younger, rare progression, can spontaneously regress

5

What are the clinical features of penile invasive carcinoma?

circumcision confers protection
typically 40-70
metastasizes to inguinal and iliac nodes
squamous --> keratin pearls!

6

What are predisposing factors for testicular torsion?

increased mobility to to absence of gubernaculum or atrophy

7

What is seen w testicular torsion?

red and hemorrhagic parenchyma
coagulative necrosis

8

What are sequelae of cryptorchidism?

atrophy and sterility
10X increase of germ cell tumors - bilateral risk even if unilateral cryptorchidism

9

What are the different types of testicular tumors?

most are germ cell tumors
seminoma or non-seminomatous (embryonal carcinoma, yolk sac tumor, teratoma, chorciocarcinoma)

10

Compare and contrast seminomas vs. non-seminomatous tumors of the testicles.

pure vs. mixed histology
orchiectomy and RADIOtherapy vs. orchiectomy and CHEMOtherapy
no serum markers (LDH nonspecific) vs. HCG & AFP
lymphatic spread vs. lymphatic & hematogenous
low stage presentation vs. high stage

11

What are the morphologic highpoints of classic seminoma?

sheets polygonal cells, clear cytoplasm, prominent cherry red nucleoli separated by fibrous bands w lymphocytes

12

What are the morphologic highpoints of embryonal carcinoma?

pleomorphic epithelioid malignant cells forming gland-like structures, mitotic features

13

What are the morphological high points of yolk sac tumor?

perivascular rosettes = schiller-duval bodies
AFP!

14

What are the morphological high points of choriocarcinoma of the testes?

admixture of syncytio- and cytotrophoblasts - need both
hCG!

15

What are inflammatory conditions of the prostate?

acute and chronic bacterial prostatitis: e. coli
chronic abacterial prostatitis: most common, maybe chlamydia, ureaplasma

16

What are the features of BPH?

does not predispose to cancer, DHT and estrogen accumulation

17

What is the role of 5alpha-reductase in the pathogenesis of BPH?

converts testosterone into DHT

18

What can help diagnose prostate cancer?

hypoechoic areas on ultrasound
PSA >10 - but more specific ways:
PSA density, velocity, or percent free PSA (lower w cancer)
PSA can help monitor response to therapy

19

What are etiological factors in the dev of prostate cancer?

common in African Americans, rare in Asians
1st degree relatives at increased risk, fatty diet?

20

What is the pathology of prostate cancer?

mostly adenocarcinomas
spread by lymphatic and hematogenous: lots to bone - osteoblastic!
peripheral nodules (BPH more central)

21

What is seen microscopically w prostate cancer?

back to back gland proliferation
large nucleus w cherry red nucleoli
pink amorphous secretion
perineural invasion

22

What is prostatic intraepithelial neoplasia (PIN)?

premalignant lesion of prostate - graded as low or high grade, but only high grade usually found