Urogenital Pathology

Question 1

Symptoms of nodular hyperplasia

Answer 1

Urgency
Difficulty starting micturation
Decreased stream size
Increased frequency
Incomplete bladder emptying
Nocturia

Question 2

What is another name for nodular hyperplasia

Answer 2

Benign prostatic hypertrophy

Question 3

What are the 4 zones in a normal prostate gland

Answer 3

Central
Peripheral
Transitional
Periurethral

Question 4

Most carcinomas arise from which zone of the prostate gland?

Answer 4

Peripheral glands

Question 5

Nodular hyperplasia typically occurs in which zone of the prostate gland

Answer 5

Central zone- causes urinary obstruction before carcinomas

Question 6

Describe the growth of prostatic nodules in older men, compared with younger me

Answer 6

In older men they form and enlarge

In younger men (

Question 7

Main cause of nodular hyperplasia

Answer 7

Impaired cell death- acumulation of senescent cells in the prostate

Question 8

What role do androgens play in nodular hyperplasia?

Answer 8

They are able to increase cellular proliferation and inhibit cell death

Question 9

What is the most common prostatic carcinoma?

Answer 9

Prostatic adenocarcinomas (95% prostatic malignancies)

Question 10

In which age groups/ethnicities are prostatic adenocarcinomas most common?

Answer 10

> 40yrs, increase incidence in african ancestry

Question 11

Risk factors for prostatic carcinomas

Answer 11

Age
Race
Androgens/hormone levels
FH
BRCA2 mutation

Question 12

How significant are BRCA2 mutations in increasing the risk of prostatic carcinoma?

Answer 12

x20 increased risk

Question 13

What is the scoring system for prostatic carcinomas

Answer 13

Gleason’s scoring system

Question 14

What is the prognosis for prostatic carcinoma

Answer 14

Good

Question 15

Risk factors for testicular germ cell tumours

Answer 15

Prior TGCT in contralateral testicle
Crytorchidism
Impaired spermatogenesis
Inguinal hernia
Hydrocele
Disorders of sex development
Prior testicular biopsy
Atopy
Testicular atrophy

Question 16

What are the 2 types of testicular germ cell tumours?

Answer 16

Seminoma

Teratoma

Question 17

Seminomas are common in which age group

Answer 17

35-45yrs

Question 18

Teratomas are common in which age group?

Answer 18

0-20yrs

Question 19

Which type of non germ cell testicular tumour presents as testicular enlargement, usually without pain, 10% metastases.

Answer 19

Seminoma

Question 20

Which type of non germ cell testicular tumour presents as gradual testicualr swelling, usually benign pre-puberty but often malignant post puberty

Answer 20

Teratoma

Question 21

Symptoms of seminoma

Answer 21

gynacomastia, exomphalmos, infertility

Question 22

What hormones are secreted by seminomas?

Answer 22

PLAP and hCG

Question 23

What is the cause of gynacomastia in seminomas

Answer 23

hCG

Question 24

What hormones are secreted by teratomas?

Answer 24

Pure teratomatous tissues do not secrete tumour markers

Question 25

Which type of germ cell testicular tumour is well demarcated, cream coloured, homogenous and coarsely lobulated

Answer 25

Seminoma (looks like semilina)

Question 26

Which type of germ cell testicular tumour is well demarcated, solid, and multicystic

Answer 26

Teratoma

Question 27

Which type of germ cell testicular tumour is made up of monotonous polygonal cells with mostly clear cytoplasm and central nuclei divided into lobules by thin bands of fibrovascular stroma

Answer 27

Seminoma

Question 28

Which type of germ cell testicular tumour is an admixture of ectoderm and mesoderm

Answer 28

Teratoma

Question 29

Infarcted seminiferous tubules, surrounded by purulent exudate containing neutrophils and other inflammatory cells

Answer 29

Acute and chronic epididymoorchitis

Question 30

Swollen, painful and tender testes, may also have a mass indistinguishable to a neoplasm. No granulomas are present but interstitial and intratubular aggregation of epithelioid histiocytes, lymphocytes and plasma cells imparts a granulomatous appearance

Answer 30

Idiopathic granulomatous orchitis

Question 31

Non-necrotizing granulomas involving testicular parenchyma

Answer 31

Sarcoidosis of the testis

Question 32

Soft yellow, tan or brown nodules that replace normal testicular parenchyma. Tubules and interstitium are extensively infiltrated by large histiocytes with abundant eosinophilic granulomar cytoplasm.

Answer 32

Malakoplakia of testis

Question 33

The name of the large histiocytes in malakoplakia of testis

Answer 33

Von hansermann histiocytes

Question 34

An exuberant foreign body giant cell reaction to extravasated sperm, common after vasectomy

Answer 34

Sperm granuloma

Question 35

Painless scrotal swelling, unilateral or bilateral mass, infertility, scrotal fistula. Caseating granulomatous inflammation is prominent, with fibrous thickening and enlargement of the epididymis and adjacent structures.

Answer 35

Tuberculous orchitis

Question 36

Testis found in inguinal canal or upper scrotum, or abdomen

Answer 36

Cryptorchidism

Question 37

Cryptorchidism is more common on which side?

Answer 37

Right

Question 38

2 types of crytorchidism

Answer 38

Congenital and acquired

Question 39

Complications of cryptorchidism

Answer 39

Testicular atrophy Infertility Carcinoma

Question 40

2 types of hypogonadism

Answer 40

Primary and secondary

Question 41

Types of primary hypogonadism

Answer 41

``` Undescended testis klinefelter syndrome Haemochromatosis Mumps Orchitis Trauma CF Testicular torsion Varicocele ```

Question 42

Types of secondary hypogonadism

Answer 42

Pituitary failure Drugs (glucocorticoids) Obesity Ageing