Pathology (Sections 16-20) Flashcards Preview

PLE 2017: Pathology > Pathology (Sections 16-20) > Flashcards

Flashcards in Pathology (Sections 16-20) Deck (230):
1

Most common form of intestinal atresia

Imperforate anus

2

Most common type of tracheoesophageal fistula

Distal TEF with proximal esophageal atresia

3

Posterolateral diaphragmatic hernia

Bochdalek

4

Anteromedial diaphragmatic hernia

Morgagni

5

Pathophysiology: Omphalocoele

Failure of bowel to return during physiologic herniation (6th to 10th week AOG)

6

Pathophysiology: Gastroschisis

Abnormal closure of the abdominal wall, usually to the right of the umbilicus

7

True diverticulum, antimesenteric
Failed involution of vitelline/omphalomesenteric duct

Rule of 2's:
2% of population
2ft from ileocecal valve
2x in males
Symptomatic by 2 years of ages

Meckel's Diverticulum

8

Teratogens associated with pyloric stenosis

Erythromycin, Azithromycin

9

Types of Esophageal Diverticula

Zenker (Pharyngoesophageal)
(Above the UES)

Epiphrenic
(Above the LES)

10

Iron deficiency Anemia
Glossitis
Cheilosis
Esophageal Webs

Plummer-Vinson Syndrome

11

Circumferential narrowng of the esophagus brought about by thickening of mucosa and muscle

Schatzki Ring

Type A:
Above Gastroesophageal Junction

Type B:
Squamocolumnar Junction of lower esophagus

12

Triad of Achalasia

1. Incomplete LES Relaxation
2. Increased LES Tone
3. Esophageal Peistalsis

13

Longitudinal tears near GEJ from retching

Mallory-Weiss

14

Vascular anastomosis involved in esophageal varices

Esophageal branch of Left Gastric Vein

And

Azygos Vein

15

Intestinal metaplasia of the squamous esophageal epithelium

Complication of chronic GERD

Barrett Esophagus

16

Common site of SCCA in the esophagus

Middle third

(versus AdenoCA: Distal Third)

17

Proximal duodenal ulcers associated with severe burns and trauma

Curling Ulcers

18

Esophageal, gastric, or duodenal ulcers in patients with elevated ICP (direct vagal stimulation and increased acid secretion)

Cushing Ulcers

19

Most common cause of diffuse, acute chronic gastritis

Autoimmune gastritis

20

H. Pylori virulence factors

1. Lophotrichus flagella
2. Adhesins
3. Urease
4. CagA Toxin

21

Type 4 HSR causing destruction of gastric parietal cells directed against the H/K ATPase Pump

Spares the Antrum

Autoimmune Gastritis

22

Histologic change associated with autoimmune gastritis

Endocrine Cell Hyperplasia

(versus Intestinal Metaplasia in H. pylori)

23

Most common complication of PUD

Bleeding

24

Most common form of PUD

Antral/Duodenal
(H. pylori associated)

25

Mucosal atrophy
Corpus-predominant
Decreased gastric acid secretion
Pain with meals
No nocturnal awakening

Gastric Ulcer

26

Triad of Zollinger-Ellison Syndrome

1. Pancreatic Cell Tumor
2. Gastric Hypersecretion
3. Peptic Ulcer Disease

27

Hypertrophic gastropathy with resulting hypoproteinemia due to protein-losing enteropathy

Menetrier Disease

28

Type of gastric polyp
Lined with flattened chief/parietal cells
Absent a nflammation
No dysplasia

Fundic gland polyp

29

Most common type of gastric polyp

Inflammatory/Hyperplastic (85%)

30

Most common malignancy of the stomach

Adenocarcinoma

31

Most common site of extranodal lymphomas

Stomach

32

Most common abdominal mesenchymal tumor

Gastrointestinal stromal tumor

33

Most common site of gastric adenocarcinoma

Antral, Lesser Curvature

34

Gastric adenocarcinoma
Abnormality in WNT signalling
Exophytic, ulcerative lesions

Intestinal Type

35

Gastric adenocarcnoma
Loss of E-Cadherin
Infiltrative lesions with desmoplasia
Leather bottle appearance (lintis plastica)
Poorly cohesive cells

Diffuse Infiltrative

36

Most common inducer of MALT lymphoma

H. pylori Infection

37

Most important prognosticating factor for GI Carcinoids

Location

*Midgut tumors often multiple and aggressive

38

Most common site of GI Carcinoids

Small Intestine (40%)

39

Arise from Cajal Cells
cKIT Mutation (75-80%)

Gastrointestinal Stromal Tumor

40

Most common cause of intestinal obstruction

Hernias

*in less than 2 years: intussusception

41

Most common sites of ischemic bowel disease

Splenic Flexure
Sigmoid
Rectum

42

Hallmark of malabsorptive syndromes

Steatorrhea

43

Cell-mdiated immune reponse to gliadins
CD8+ T-Cells in villi
Diagnostic: Transglutaminase antibodies
Increased risk of Enteropathy-associated T-Cell Lymphoma

Celiac Disease

44

Most common bacterial enteric pathogen

Campylobacter jejuni

45

Associated with Whipple Disease
Ssx of GITB, but AFB (-)

Trophyrema whippeli

46

Common cause of severe childhood diarrhea; associated with diarrheal mortalities worldwide

Rotavirus

47

Causes almost half of gastroenteritis outbreaks worldwide

Norwalk Virus

48

Inflammatory bowel disease
Transmural involvement
Any part of the GIT
Hallmark: Non-caseating granuloma

Crohn's Disease

49

Inflammatory bowel disease
Mural Involvement
Involves colon and rectum

Ulcerative Colitis

50

Most common site of diverticular disease

Sigmoid

51

Absent in False Diverticula

Muscularis propria

52

Single most important factor that relates to malignancy risk in GIT adenomas

Size
(> 4cm)

53

Elephant-feet Glands

Sessile serrated adnoma
(high malignant potential)

54

Multiple hamartomatous polyps, mucocutaneous hyperpigmentation along GIT
Arborizing networks of smooth muscle
Autosomal Dominant

Peutz-Jegher Polyps

55

Multiple (at least 100) colorectal adenomas during teenage years

APC Mutation
Pathgenesis: Hyperactive WNT signalling

Familial Adenomatous Polyposis

56

Familial clustering of the following tumors:
Colorectal
Endometrial
Ovarian
GIT, HBT
Neurologic
Skin

Pathogenesis: Defective DNA Repair

Hereditary nonpolyposis colon cancer

57

Diagnostic criteria used for HNPCC

Amsterdam Criteria

58

Drug considered protective against GIT adenocarcinoma

NSAID
(decreased PGE2)

59

Most common site of metastases for GIT malignancies

Liver

60

Gross description of colon cancers

Proximal: Exophytic, Bulky

Distal: Annular

61

Vascular plexuses involved in hemorrhoid formation

Internal:
Superior Hemorrhoidal Plexus

External:
Inferior Hemorrhoidal Plexus

62

Most common cause of appendiceal obstruction

Children:
Lymphoid Hyperplasia

Adults:
Fecalith

63

Mucinous ascites due to peritoneal seeding of mucinous tumors

Pseudomyxoma Peritonei

64

Most common appendiceal tumor

Carcinoid

65

Pathophysiology: Ormond Disease

IgG mediated retroperitoneal sclerosis

66

Functions of hepatic stellate cells

Vitamin A Storage
Scar formation in hepatic injury

67

Etiology of rapid hepatic necrosis in ALF without evidence of repair

Drug-induced

68

Pathophysiology: Hepatorenal Syndrome

Decreased GFR due to afferent arteriole vasoconstriction (c/o RAAS) from renal hypoperfusion

Initiating Event: Systemic Vasodilation

69

Most common cause of portal hypertension

Cirrhosis

70

Pathologic derangements of portal hypertension

Sinusoidal remodelling and intrahepatic shunting

Hyperdynamic pulmonary circulation

71

Councilman Bodies

Eosinophilic inclusions in viral hepatitis

72

Autoimmune hepaitis
Middle aged and older
ANA, Anti-SMA autoantibodies
Better prognosis

Type 1

73

Autoimmune hepatitis
Children and teenagers
Anti-LKM-1 autoantibody
Less favorable prognosis

Type 2

74

Drugs that trigger an immune response via binding of large molecules

Hapten

75

Alcohol consumption associated with ALD

80g/day

76

Morphologic patterns of ALD

Hepatocellular steatosis
(Lipid droplets; reversible)

Alcoholic steatohepatitis
(Swelling and necrosis)

Steatofibrosis
(Chicken-wire Fibrosis)

77

Mallory-Denk Bodies

Amorphous, eosinophilic material seen in ALD

78

Most common metabolic liver disease

Non-alcoholic fatty liver disease

79

Triad of Hemochromatosis

1. Micronodular cirrhosis
(mediated by activation of stellate cells by iron)

2. DM
(pancreatic fibrosis)

3. Skin pigmentation
(Slate gray skin)

80

Impaired copper excretion in bile
ATP7B mutation
Putaminal atrophy (movement disorders)
Kayser-Fleisher Ring (corneal limbus)

Wilson Disease

81

Autosomal ecessive
PiZZ genotype
Panlobular emphysema (elevated elastase)
Liver damage (misfolded CHON accumulation)

Alpha-1-antitrypsin Deficiency

82

Conditions associated with impaired uridine diphosphate glucoronyltransferase

Criggler-Najar Type 1
(AR, absent activity)

Criggler-Najar Type 2
(AD, decreased activity)

Gilbert
(AR, decreased activity)

83

Conjugated hyperbilirubinemia
MRP2 Mutation
Impaired biliary excretion

Dublin-Johnson Syndrome

84

Conjugated hyperbilirubinemia
Mechanism unknown
#PinoyPride

Rotor Syndrome

85

Most common cause of bilde duct obstructions

Adults:
Gallstones

Children:
Biliary Atresia

86

Charcot Triad

1. Fever
2. Jaundice
3. RUQ Pain

87

Complete or partial obstruction of the extrahepatic BT within first 3 months of life

Single most common cause of hepatic mortality in early childhood

Extrahepatic biliary atresia

88

Types of Biliary Atresia

Fetal
(Malformation)

Perinatal
(Postnatal destruction)

89

Median age 50
Female
Associated with Sjogren Syndrome (70%)
AMA positive (95%)
Loss of small ducts

Florid duct lesion
Mallory-Denk Bodies

Primary Biliary Cirrhosis

90

Median Age 30
Male
Associated with IBD (70%)
ANCA positive(65%)
Involvement of all sizes of hepatic ducts

Primary Sclerosing Cholangitis

91

Triad of Choledochal Cysts

1. Pain
2. Jaundice
3. Abdominal Mass

92

Congenital cystic dilatation of intrahepatic bile ducts

Associated with choledochal cysts

Caroli disease

93

Congenital bile duct hamartomas

Associated with polycystic kidney disease

Von Meyenbrg Complex

94

Infarct of Zahn

Intrahepatic thrombosis

95

Sinusoidal dilatation due to impediment in hepatic blood outflow

Peliosis hepatis

96

Thrombotic obstruction of more than 2 hepatic veins

Hemorrhagic centrilobular necrosis

Budd-Chiari Syndrome

97

Sinusoidal remodelling secondary to toxic endothelial injury

Sinusoidal Obstruction Syndrome

98

Components of Nutmeg Liver

Centrilobular Congestion
(RSHF)

Centrilobular Ischemic Coagulative Necrosis
(LSHF)

99

Centrilobular fibrosis in long-standing congestion

Cardiac sclerosis

100

Most common benign hepatic tumor

Cavernous Hemangioma

101

Most common liver tumor in early childhood

Hepatoblastoma

102

Most common tumor of the liver

Metastasis

103

Most common primary malignant tumor pf the liver

Hepatocellular Carcinoma

104

Second most common primary malignancy of the liver

Cholangiocarcinoma

105

Tumor marker for HCC

Alpha-fetoprotein

106

Pattern and site of metastasis for HCC

Hematogenous to the Lungs

107

HCC Variant
Oncocytes in clusters
Parallel lamellae of dense connective fiber

Fibrolamellar HCC

108

Common location of Cholangiocarcinoma

Perihilar (Klatskin Tumor)

109

Most common congenital anomaly of the gallbladder

Folded fundus
(Phrygian Cap)

110

Most common biliary tract disease

Cholelithiasis

111

Types of acute cholecystitis

Acute calculous (90%)

Acute acalculous (ischemic)

112

Rochitansky-Aschoff Sinuses

Mucosal outpouching of the gallbladder

113

Extensive, dystrophic calcification of the gallbladder

Porcelain Gallbladder

114

Atrophic, dilated GB with clear secretions

Hydrops

115

Failure of fusion of fetal pancreatic duct systems

Most common congenital anomaly of the pancreas

Pancreatic divisum

116

Most common site of ectopic pancreatic tissue

Stomach, Duodenum

117

Mutation involved in pancreatic agenesis

PDX1

118

Most frequntly mutated oncogene in pancreatic cancer

KRAS

119

Most common location of pancreatic cancer

Head

120

Tumor marker for pancreatic cancer

CA 19-9

121

Common site of metastasis for pancreatic cancer

Liver, Lungs

122

Acute Kidney Injury

1. Increase in SCr by 0.3 in 48 hrs
2. Increase in SCr by 1.5x baseline within 7 days
3. Urine < 0.5mL/kg/hr for 6 hrs

123

Nephritic Syndrome
Type 3 HSR
EM: Subepithelial bumps
IF: IgG, C3 positve

Most common cause of nephritic syndrome in children

PSGN

124

Histologic hallmark of RPGN

Crescent formation

125

Electron Microscopy and Immunofluorescence in RPGN

Type I
EM: Ruptured GBM
IF: Linear deposits

Type II
EM: Lumpy-Bumpy deposits
IF: Granular deposits

Type III
EM, IF: No deposits

126

Males in their 20's
Smokers
Hemoptysis and Renal Failure

Antibodies against Collagen type 4

Goodpasture Syndrome

127

Nephrotic Syndrome
EM: Effaced foot processes
Responsive to steroids

Most common cause in children

Minimal Change Disease

128

Nephrotic Syndrome
EM:"Spike and Dome" subepithelial deposits
IF: Granular deposits

Second most common cause in adults

Membranous Nephropathy

129

Nephrotic Syndrome
Associated with HIV, Heroin
LM: Mesangial proliferation, hyalinosis
EM: Effacement of foot processes
IF: Non-specific trapping in hyalinosis

Most common cause in adults

Focal Segmental Glomerulonephritis

130

Difference between MPGN Type 1 and 2

Type 1
Classical and alternative complement activation
WITH Immune Complex Deposition

Type 2
Also known as Dense Deposit Disease
Alternative complement activation
WITHOUT Immune Complex Deposition

131

Nephrotic Syndrome
IgA deposition localized to kidneys (mesangial)
Gross hematuria post-infection (GI, Pulmo)
IF: Mesangial deposit of IgA

Most common GN worldwide

IgA Nephropathy
(Berger Disease)

132

Nephrotic Syndrome
Systemic IgA Deposition
Purpuric skin lesions, GI Bleed, Arthralgias
IF: Mesangial deposit of IgA

Henoch-Schonlein Purpura

133

Defective assembly of Type 4 Collagen
Isolated Hematuria
EM: Diffuse thinning of GBM

Thin Basement Membrane Lesion

134

Defective assembly of Type IV collagen
Posterior Lens dislocation
Hearling Loss
Hematuria
EM: Basket-Weave Appearance

Alport Syndrome

135

Top causes of AKI

1. Pyelonephritis
2. Drug-induced TIN

136

Pathophysiology: Adult Polycystic Kidney Disease

PKD1 (85%, more severe) and PKD2 (15%) Mutations

137

Pathophysiology: Childhood Polycystic Kidney Disease

PKHD1 Mutation

138

Most commn stones in urolithiasis

Calcium Oxalate, Calcium Phosphate (70%)

139

Types of Renal Stones

Calcium Oxalate
(Acidic, Opaque)

Struvite
(Basic, Opaque)

Uric Acid
(Acidic, Lucent)

Cystine
(Acidic, Opaque)

140

Renal tumor associated with Tuberous Sclerosis

Angiomyolipoma

141

Benign renal tumor arising from the intercalated cells of the collecting duct

Oncocytoma

142

Benign renal tumor arising fr, tubular epithelial cells in a palm frond configuration

Renal Papillary Adenoma

143

Most common renal malignancy

Renal Cell Carcinoma

144

Second most common renal malignancy

Wilms Tumor

145

Third most common renal malignancy

Urothelial carcinoma of the pelvocalyceal system

146

Common in:
Males
60's-70's
Smoker

Most common renal malignancy

Renal Cell Carcinoma

147

Sites of predisposition: Renal Cell Carcinoma

Renal Cell:
Proximal Tubule

Papillary:
Distal Tubule

Chromophobe:
Intercalated cells of the Collecting Ducts

148

Triad of Renal Cell Carcinoma

1. Hematuria
2. Flank Pain
3. Palpable Mass

149

Renal malignancy associated with Lynch Syndrome and Analgesic Nephropathy

Urothelial Carcinoma of the Renal Pelvis

150

Metastatic spread by Renal Cell Carcinoma

Hematologic to the Lungs, Bones

151

Most common cause of hydronephrosis in children

Ureteropelvic Junction Obstruction

152

Most common primary malignancy in the Ureters

Urothelial Carcinoma

153

Most common and serious congenital anomaly of the ureters

Vesicoureteral Refux

154

Consequences of a patent Urachus

Fistula between umbilicus and urinary bladder (total patency)

Urachal Cyst (partial patency)

155

Most common bacterial pathogens of acute cystitis

Escherichia coli
Klebsiella
Proteus
Enterobacter

156

Viral cause of hemorrhagic cystitis

Adenovirus

157

Cytotoxic drug associated with hemorrhagic cystitis

Cyclophosphamide

158

Triad of Acute Cystitis

1. Frequency
2. Lower abdominal pain'
3. Dysuria

159

Common in women
Intermittent, severe suprapubic pain
Frequency, urgency, hematuria, dysuria
Cystoscopy: Punctate hemorrhages, fissures, Hunner Ulcers

May mimic carcinoma-in-situ

Chronic Pelvic Pain Syndrome
(Interstitial Cystitis)

160

Hunner Ulcers

Chronic mucosal ulcers found in patients with Interstitial Cystitis

161

Seen in cases of chronic E. coli and Proteus infections
Defect of phagocyte function
Michaelis-Guttman Bodies

Malakoplakia

162

Michaelis-Guttman Bodies

Macrophages with abundant lysosomal calcium deposits

Seen in Malakoplakia

163

Form of cystitis that mimics Urothelial carcinoma both clinically and histologically

Arises from irritation secondary to catheterization

Polypoid Cystitis

164

Brunn nests (urothelial cells) grow downward into lamina propria; presents as glandular metaplasia or cyst formation

Cystitis Cystica et Glandularis

165

Implantation of renal tubular cells at sites of injured urothelium

Nephrogenic Adenoma

166

Males
Smokers
5th to 8th decade of life
Mediated by 9p and 9q deletions/monosomy
Presents as painless hematuria, frequency, urgency

Most common histologic type: Urothelial

Bladder Cancer

167

Infectious cause of SCCA in the bladder

Schistosoma haematobium

168

Denuding Cystitis

Few malignant cells on a largely denuded basement membrane with inflamed stroma.

Seen in carcinoma-in-situ of the urinary bladder

169

Intravesically administered vaccine used as treatment for non-invasive urothelial carcinomas

Attenuated strain of Mycobacterium bovis

Bacille-Calmette-Guerin

170

Most important prognostic factor in invasive urothelial carcinoma of the bladder

Staging

171

Most common benign tumor of the bladder

Leiomyoma

172

Most common sarcoma in children

Embryonal Rhabdomyosarcoma
(Sarcoma Botryoides)

173

Most common sarcoma in adults

Leiomyosarcoma

174

Most common cause of urinary bladder obstruction in males

Nodular prostatic hyperplasia

175

Most common cause of urinary bladder obstruction in females

Cystocoele of the bladder

176

Non-infectious cause of urethritis

Reiter Syndrome

177

Inflamed granulation tissue in the urethra, covered by a friable mucosa

Urethral Caruncle

178

Distribution of Urethral Malignancies

Proximal:
Urothelial Carcinoma

Distal:
Squamous Cell Carcinoma

179

Pathophysiology:
Hypospadias, Epispadias

Malformation of the urethral groove

180

Most common cause of phimosis

Scarring from infection

181

Infection of the glans and the prepuce

Balanoposthitis

182

Pathogen responsible for Condyloma Acuminatum

HPV 6, HPV 11

183

HPV 16 Infection
Solitary gray-white, opaque plaque

Progresses to SCCA in 10% of cases

Bowen Disease

184

HPV 16 infection
Solitary, shiny, red, velvety plaque

Erythroplasia of Queyrat

185

HPV 16 Infection
Multiple reddish-brown papules

Does not progress to SCCA

Bowenoid Papulosis

186

Locally invasive, but rarely metastatic verrucous tumor of the penis

Buschke-Lowenstein Tumor
(Giant Condyloma Acuminatum)

187

Most important prognostic factor in penile malignancy

Staging

188

Most common site of cryptorchidism

Inguinal Canal

189

Most common phase of arrest in Cryptorchidism

Inguinoscrotal
(4th to 7th month AOG)

190

Anatomic predisposition of the various patholog processes in male gonads

Epididymis:
Inflammation, Gonorrhea (initially), EPTB (initially)

Testes:
Tumors, Syphilis (initially)

191

Pathogenesis of orchitis and epidydimitis

Ascending or lymphatic spread of UTI

192

Testicular mass with or without fever
Non-caseating granulomas in spermatic tubules

Granulomatous / Autoimmune Orchitis

193

Acute interstitial orchitis following a previous PAROTITIS
Unilateral testicular involvement
Not associated with infertility

Mumps Orchitis

194

Urologic emergency
Hemorrhagic infarction from twisting of the spermatic cord
Golden period: 6 hours

Testicular Torsion

195

Adult-type testicular torsion results from this bilateral anatomic defect in adolescents

Bell-clapper Deformity
(increased mobility of testes)

196

Most common cause of painless testicular enlargement

Testicular neoplasia

197

Histologic types of Testicular Tumors

Germ Cell (95%, aggressive)

Sex cord-stromal (5%, less aggressive)

198

Prescursor lesion of most Testicular Germ Cell Tumors

Intratubular germ cell neoplasia

199

Most common route of lymphatic spread by Germ Cell Tumors

Retroperitoneal para-aortic lymph nodes

200

Most common route of hematogenous spread by Germ Cell Tumors

Lungs
Liver
Brain
Bones

201

Clinical division of GCT
Diagnosed at Stage I (70%)
Lymphatic Spread
Radiosensitive
Cells resemble primordial germ cells

Seminomatous

202

Clinical division of GCT
Diagnosed at Stage II or III (60%)
Hematogenous spread
Radioresistant
Undifferentiated Cells

Non-seminomatous

203

Staging of GCT

Stage I
Confined to testes, epididymis, or spermatic cord

Stage II
Spread to subdiaphragmatic LN

Stage III
Spread to retroperitoneal LN or those above diaphragm

204

Seminomatous GCT
Occurs after puberty
Precursor lesion: ITGCN
Ovarian equivalent: Dysgerminoma
Gray-white, lobulated mass

Most common GCT

Seminoma

205

Seminomatous GCT
Occurs at 6th decade of life and beyond
No precursor lesion
No ovarian equivalent
Well-circumscribed, pale-gray, multinodular mass

Spermatocytic Seminoma

206

Types of Seminoma

Typical/Classic
(Large polyhedral cells, clear cytoplasm, central nucleus)

Anaplastic
(Same as typical, with atypia)

207

20's to 30's
Precursor lesion: ITCGN
Common component of Mixed GCT's (80%)
More aggressive than Seminomas
Small, poorly demarcated masses with foci of hemorrhage

Embryonal Carcinoma

208

<3 years old
No precursor lesions
Excellent prognosis
Non-encapsulated, solid, homegnous, yellow-white mass
Schiller-Duval Bodies, Hyaline-like Globules
(+) AFP is highly characteristic

Most common testicular tumor in children less than 3 years

Yolk Sac Tumor
(Infantile Embryonal Carcinoma, Endodermal Sinus Tumor)

209

Highly malignant
Hematogenous Spread with Brain metastases
Clinically, normal sized testes and/or small nodule
Tumor Marker: HCG
Histology: Cytotrophoblasts and Syncytiotrophoblasts

Choriocarcinoma

210

Complex tumor with various components derived from more than 1 germ cell layer

Second most common testicular tumor in infants and children

Teratoma

211

Best prognostic factor for Teratomas

Age
(Post-puberty: All considered malignant)

212

Differentiates Immature from Mature Teratomas

Degree of Differentiation
(Less in Immature)

213

Malignant transformation of a Teratoma

Non-germ cell malignancy arising from within a teratoma
Usually chemoresistant
Retains i(12p) Mutation from Teratoma precursors

214

Schiller-Duval Bodies

Central blood vessels enveloped by tumor cells within a space lined by tumor cells

Seen in Yolk Sac Tumors

215

Second most common GCT in adults (60%)

Mixed GCT

216

Sex Cord-Stromal Tumor
2nd to 6th decade of life
Gynecomastia, Precocious Puberty
Benign
Well-differentiated polygonal cells with abundant granular cytoplasm; with Crystalloids of Reinke (rod-shaped)

Leydig Cell Tumor

217

Sex Cord-Stromal Tumor
First 4 decades of life
Hormonally silent
Most are benign
Trabeculae and cords recemble seminiferous tubules

Sertoli Cell Tumor

218

Most common form of testicular neoplasm in males greater than 60 years of age

Testicular Lymphoma

219

Fever, chills, and dysuria
Tender, boggy prostate on DRE
Caused by E. coli, Enterococci, Staphylococci
Chronic: History of recurrent UTI
Prostatic secretions: >15 WBC/hpf

Bacterial Prostatitis

220

Painful ejaculation
Caused by Chlamydia, Trichomonas, Ureaplasma, and Mycoplasma
Prostatic secretions: >10 WBC/hpf
(-) Bacterial Cultures

Abacterial Prostatitis

221

Most common site of prostatic intraepithelial neoplasia (PIN), and prostatic malignancy

Peripheral Zone

222

Most common site of nodular prostatic hyperplasia (NPH)

Transitional Zone

223

Prostatic neoplasia
Mediated by Dihydroxytestosterone (DHT)
Fibromuscular and glandular hyperplasia leading to nodule formation

NOT a premalignant lesion

Nodular Prostatic Hyperplasia

224

> 50 years
High fat diet, Obesity, Alcoholism
Adenocarcionoma without basal layer
Presents as dysuria (most common)
Direct local extension to seminal vesicles and bladder
Hematogenous spread to Lumbar Spine

Diagnostics: PSA (Non-specific)

Prostatic Adenocarcinoma

225

PTEN Mutation in Prostatic CA

Gives resistance to anti-androgen therapy

226

ERG-ETV1-TMPRSS2 Mutation in Prostatic CA

Associated with invasiveness; very common mutation

227

Diagnostic used in the context of elevated PSA given a normal prostate biopsy

PCA3

228

Prostate CA scoring system based on the two most dominant glandular patterns on histology

Gleason Scoring System

229

Best prognostic factor for Prostate CA

Stage and Grade

230

Most common cause of renal artery stenosis

Atherosclerosis