Pathology of the Male GU I: Prostate Flashcards Preview

Pathology > Pathology of the Male GU I: Prostate > Flashcards

Flashcards in Pathology of the Male GU I: Prostate Deck (47):
1

What type of cells line the urinary tract?

Urothelium

2

What is the most common cause of hydronephrosis in
children?

Ureteropelvic Junction Obstruction

3

- von Brunn’s nests with degenerated central cells to form small cystic cavities
- Translucent, submucosal, pearly- yellow cysts, usually up to 5mm

Urethritis (AKA Cystitis Cystica)

4

Vesicoureteral Reflux

Valve defect that can lead to the reversal of the
urine - can cause pyelonephritis

5

Exstrophy

Developmental failure in the anterior wall of the abdomen and in the bladder

6

Interstitial Cystitis (Chronic Pelvic Pain Syndrome)

Non-bacterial form of cystitis seen mostly in females and is associated with allergies and autoimmune diseases and mast cells are often a hallmark

7

Malakoplakia

Recurrent fever, bladder irritability and pain, hematuria, pyuria, weight loss.

8

What is seen on cystoscopy with malakoplakia?

Multiple raised soft yellow to brown plaques and nodules

9

Michaelis-Gutmann Bodies

Blue targeted calcospherules seen on histology in malakoplakia

10

What is malakoplakia associated with?

Chronic bacterial infection

11

Leukoplakia

Long-term irritation or chronic infection which appears grossly as gray-white areas and has increased risk of carcinoma of bladder

12

What is a feature of the treatment of bladder cancer?

It has the highest cost per patient from diagnosis to death

13

What gender is more affected by bladder cancer?

Males 3:1 - usually older males

14

What is the clinical presentation of bladder cancer?

- Painless hematuria
- Frequency
- Urgency

15

What are some major risk factors for bladder cancer?

- Cigarette smoking
- Arylamines
- Chronic cystitis

16

What are the two pathways for the development of urothelial carcinoma?

Papillary and Non-papillary

17

What pathway is the most common for the development of urothelial carcinoma?

Papillary Pathway

18

Papillary Pathway

More common and develops with hyperplasia which is genetically stable with FGFR3 mutations. As it develops, it leads to a low grade carcinoma.

19

Non-papillary Pathway

Less common and develops with dysplasia and is genetically unstable with some having p53 mutations. It can develop into high grade carcinoma or carcinoma in situ.

20

What mutation is more likely in a low grade urothelial carcinoma?

FGFR3

21

What mutation is more likely in a high grade urothelial carcinoma?

p53

22

BCG Vaccine

Bacillus Calmette-Guérin - Attenuated strain of Mycobacterium tuberculosis and is used to prevent recurrence of bladder cancer

23

What is the prognosis of low grade bladder cancer?

VERY good

24

What is the prognosis of high grade bladder cancer?

Pretty good - 75% 10 yr survival rate

25

Most common cause of Nongonococcal urethritis...

E. coli

26

What is the most common location for prostate cancer?

Posterior zone

27

What is the most common location for benign prostatic hyperplasia?

Central Zone

28

What cell layers it the prostate comprised of?

- Secretory Cells
- Basal Cells

29

Benign Prostatic Hyperplasia

Hyperplasia of prostatic glands and stroma - extremely common with increasing age

30

What are some complications of BPH?

- Compression of urethra – difficulties with urination
- Retention of urine in the bladder

31

What are the main mediators of prostate growth?

Androgens - mainly DHT

32

How is BPH treated?

Inhibitors of 5-alpha reductase

33

Nodular Hyperplasia of Prostate

Prostatic enlargement due to presence of nodules in the preprostatic region

34

What is the most common cancer in males?

Prostate Cancer

35

Do most men with prostate cancer die from prostate cancer?

No

36

What race is at increased risk of prostate cancer?

African Americans

37

What are some mutations in the androgen receptors that increase prostate cancer risk?

X-linked AR gene contains a polymorphic sequence composed of CAG repeats - patients with shortest CAG repeats have the highest androgen sensitivity

38

What mutation greatly increases prostate cancer risk?

BRCA2 germline mutation on Ch13 - 20 fold increased risk for PCA

39

What is the most common epigenetic alteration in prostate cancer?

Most common epigenetic alteration in PCA hypermethylation of gluthation S-transferase

40

What are some biomarkers of prostate cancer?

- PSA
- AMACR

41

Prostate Specific Antigen (PSA)

Secreted into seminal fluid where dissolves seminal
coagulum. Produced by epithelial cells of normal, hyper plastic and cancerous prostatic tissue and is elevated in prostate cancer.

42

Prostatic Intraepithelial Neoplasia

Proliferation of neoplastic cells within large ducts

43

What is the most common morphology of prostate cancer?

Most often - tumor is not grossly visible

44

What is the best marker to predict prognosis of prostate cancer?

Gleason Score

45

What is a common metastasis of prostate cancer?

Osteoblastic Tumor Metastases

46

What is the treatment for localized prostate cancer?

Radical Prostatectomy

47

What is the treatment for metastatic prostate cancer?

Androgen Deprivation

Decks in Pathology Class (203):