Disorders Of Male Genital Tract

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Penile Carcinoma (erythroplasia of queyrat)

*red rash leison on glans

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Taken from shaft of penis

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Penile Carcinoma in situ (Bowen Disease)

*atypical squamous cell that do NOT break through basement membrane

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Could be either Balantitis (benign) or penile carcinoma in situ ... requires biopsy!

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Penile Carcinoma in situ (bowenoid papulosis)

*can present as non-healing warts

*associated with HPV type 16

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Take from glans of penis

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Invasive Penile Carcinoma

*broke through basement membrane

*spreads quickly to inguinal LN

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Taken from scrotum

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Extramammary Paget's Disease

*intraepidermal adenocarcinoma w/ clear cytoplasm cells

*often occurs with other underlying malignancy

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Pt complained of one testis feeling heavier

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Seminoma

*"Fish-flesh" appearance with no hemorrhage or necrosis

*most common germ cell tumor of testis

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Stained + for placental Alk. Phos.

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Seminoma

*sheets of uniform cells with large central nuclei with 1-2 nucleoli (red)

*area infiltrated with non-tumor lymphocytes (black)

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taken from testis

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Intratubular Germ Cell Neoplasia (ITGCN)

*carcinoma in situ that most germ cell tumors arise from (50% progress to tumor in 5yrs)

*associated with infertility

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taken from testis

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Embryonal Carcinoma

*small tumor usually occuring in mixed germ cell tumors

*Alveolar/Tubular (black arrow) appearance

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Taken from testis of a toddler with elevated AFP levels

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Yolk Sac (Endodermal Sinus) Tumor

*Yellow mucinoid tumor that often occurs in a mixed germ cell tumor

*"Schiller-Duval Bodies" (arrow - endodermal sinuses)

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Taken from testis of man with high levels of hCG

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Choriocarcinoma

*malignant tumor usually part of mixed germ cell tumor

*composed of cytotrophoblastic and syncytiotrophoblastic cells (arrow) with hemorrhage and necrosis

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taken from testis

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Teratoma

*composed of many germ cell types -- this one has glandular (red) and cartilage (black) tissue

*more common as part of mixed tumor type -- especially if it occurs in an adult

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taken from testis

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Sertolli Cell Tumor

*rare, benign, derived from sex cords

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taken from testis in pt with precosious puberty

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Leydig Cell Tumor

*rare, benign, stromal cell tumor that secretes testosterone causing early puberty

*characterized by "Crystalloid of Reinke" (arrow)

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taken from prostate

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Prostate Cancer

*simple glandular appearance occurring in peripheral zone of prostate

*can spread via LN to bone to cause OsteoBLASTIC lesions

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taken from prostate

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Prostate Cancer

*staining shows cancer cell in pink (upper arrow) with a lack of basal cells (bottom arrow)

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Condyloma Accumulatnum (genital warts)

*HPV 6 or 11

*Koilocytic change, not malignant

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Testricular Atrophy

*Causes: Iliac atherosclerosis (most common), orchitism, cryptorchidism, Estrogen

*Normal & Sclerosed tubules w/ Leydig hypertrophy

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Pt has dysuria, frequeny, low-back pain, and Increased PSA

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Prostatitis

*Acute commonly bacterial (E. coli)

*Chronic commonly abacterial (Chlamydia, Uroplasma)

*Arrow shows leukocyte infiltrate

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BPH (Nodular Hyperplasia)

*Obstructive LUDS (can cause bladder dilation/hypertrophy and stones), slightly elevated PSA (<10)

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BPH (Nodular Hyperplasia)

*Distinct nodules in Periurethral & Transitional zones due to increased DHT sensitivity

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BPH (Nodular Hyperplasia)

*complex gland hyperplasia