Summer Exam II Flashcards
(28 cards)
Testicular Inflammatory Lesions
- Testicular inflammatory lesions:
STDs (Sexually Transmitted Diseases) - Nonspecific epididymitis: Usually caused by a urinary tract infection (UTI).
- Orchitis: A rare complication of mumps infection.
-Mumps infection can lead to testicular swelling and potential infertility in adults.
-Tuberculosis (TB) can also cause inflammation with granulomas in the testicles.
-Mumps orchitis shows a specific type of inflammation with lymphoplasmacytic infiltrate and can lead to tissue death and infertility.
Testicular Cancer
- The most common cancer in young men
- Firm, painless enlargement of the testis
- Seminomas and non-seminomas
(Seminoma is a malignant germ cell tumor that involves most commonly the testicle or less frequently the mediastinum, the retroperitoneum, or other extra-gonadal sites.)
- Curable if detected early
Clinical Features of Testicular Cancer
- Common in men between 15-35
- Firm, painless enlargement of the testis
- History of cryptorchidism in 10% cases
- Some present with metastases
- Treatable-curable! If detected early
Testicular Cancer Classification
- Seminoma
- Non-seminoma
-Embryonal carcinoma
-yolk sac tumor
-Choriocarcinoma
-Teratoma
Seminoma
- Half of all testicular cancers
- Arise from germinal epithelium of seminiferous tubules
- “Spermatocytic” variant occurs in older patients; better prognosis
Nonseminomas
- Embryonal carcinomas (undifferentiated stem cells)- Lance Armstrong
- Yolk sac tumor (yolk sac cells)- malignant
- Choriocarcinoma (immature placental cells)
- Teratoma (somatic tissue cells)
- prepubertal males, teratomas are typically benign
-teratomas in postpubertal males are malignant
Tumor markers
- Important for staging and follow-up
- Human chorionic gonadotropin
-normally made by placental cells
-Always elevated in choriocarcinoma, sometimes elevated in seminoma - alpha-fetoprotein (AFP)
-normally made by fetal yolk sac and other cells
-Elevated in yolk sac tumors and embryonal carcinoma
Treatment of Testicular Cancer
- Overall, prognosis is good
-If detected early, 90% cure rate
-8000 new cases a year, only 400 deaths. - Seminomas
- Often remain localized until large
-Metastasize locally first, then later, distantly
-VERY sensitive to radiation and chemotherapy - Nonseminomas
-Metastasize earlier, farther
-Worse prognosis
Male Reproductive System
Prostate
-Benign prostatic hyperplasia
-Carcinoma
Benign Prostatic Hyperplasia (BPH)
VERY COMMON
-symptoms of urinary obstruction
-Benign proliferation of glands and stroma
-Caused by excessive androgens
Nodular Hyperplasia
VERY COMMON 90% of men have it by their 70s
-Big prostate
-usually affects central zone of the prostate
-Symptoms (in 10% of patients): hesitancy, urgency, nocturia, poor urinary stream, polyuria
-Cause: excessive androgen stimulation
Identify the condition in the photo
NODULAR HYPERPLASIA; nodule at right of field, portion of urethra to the left
Clinical features of Prostate Cancer
- Most common, 2nd deadliest cancer in men
- Peak incidence: 65-75
- Cause: androgens+genetics+ the environment
- Symptoms: asymptomatic, then palpable nodule, then local pain/obstruction
- Can metastasize to mandible, predilection for spine
Morphology of Prostate Cancer
- Most develop in peripheral zones of prostate
- Most prostate cancers are adenocarcinomas
- Better differentiated = better prognosis
Prostate-Specific Antigen (PSA)
- Enzyme made by prostatic epithelial cells
- PSA <4 is normal; PSA > 10 suggests cancer
- But pSa can go up in benign disorders too
4, Questionable usefulness as screening test
Prognosis of Prostate Cancer
- Prognosis depends on stage (and grade)
- Treatment; surgery, radiation, hormronal therapy
- Limited disease: 90% survive 10+ years
- Metastatic disease: 10-40% survive 10+ years
- Long term survival stage dependent
Herpes Simplex Type 2
- Primary herpes
-initial infection
-Painful vesicles (blister-like) on genital mucosa, skin - Dysuria, urethral discharge
- Lymphadenopathy
- Fever, malaise, muscle aches,
- Recurrent
-Virus hides in ganglion
-can periodically emerge
-Recurrent vesicles
-Usually same location (each time)
HSV 2 Histopathology
Histopathology: epithelial cells have what characteristic
Epithelial cell shave characteristic viral inclusions (cowdry type A inclusion)
Human Papillomavirus - HPV
- 70 types
- Squamous proliferations (condyloma acuminate which are gential warts)
-HPV 6 and 11
-some strains linked to cancer (16 and 18) - Most strains cause benign growths or are undetectable
HPV infected cells are called
infected cells are called koilocytes
(perinuclear cytoplasmic vacuolization)
Stages of Syphilis
- Primary stage
-chancre
-Inguinal lymphadenopathy - Secondary stage
-systemic spread of spirochete (T. pallidum)
-Generalized lymphadenopathy
-Mucocutaneous lesions - Tertiary stage
-CNS and cardiovascular lesions
-Gummas
TREATMENT: Penicillin
Congenital Syphilis
- Facial malformations
- Hutchinson’s triad
-deaf
-blind
-Malformed teeth (hutchinson’s incisors and mulberry molars)
Squamous Intraepithelial Lesion (SIL)
-used to be called “cervical intraepithelial neoplasia” (CIN)
-current term is SIL
-Low-grade SIL (LSIL): mild dysplasia
-High-grade SIL (HSIL): mod-severe dysplasia
-LSIL usually reverts to normal, but HSIL usually progresses to carcinoma
Cervical Carcinoma and HPV
HPV is detectable in almost all SIL and cancer .
- “High-risk” types:
-16, 18, 45, 31
-Found in carcinomas
-Integrate into genome, inactivate p53, RB - “Low-risk” types
-6,11
-Found in condylomas (benign lesions)
-Do not integrate into genome
