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36 Cards in this Set
- Front
- Back
- 3rd side (hint)
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In prostate, which compartment gives rise to carcinoma?
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Peripheral zone of the gland (Laterally)
What pathology is related to the transition zone |
Nodular hyperplasia (BPH)
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PSA serum value indicates what?
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The amount of prostatic epithelium present.
PSA is NOT produced by stroma |
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Conditions where PSA is elevated include the following
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Prostatitis (E.Coli)
BPH - explained by urinary Sx Carcinoma when unexplained. |
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A biopsy of a prostate was taken to investigate the cause of elevated PSA.
Lymphocytes, macrophages, and plasma cells were present in large numbers along with some neutrophils. The patient complains of pain in the lower back. What is this? |
Chronic prostatitis. A more difficult diagnosis to make because there are residual lymphs in tissue also.
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A type of prostatitis that is neither characterized by PMN or lymphocytic infiltrate is...
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Granulomatous
May be post-surgical, infectious, or idiopathic. |
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Signs of more frequent urination and difficulty with urination in an older man points to what?
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BPH after confirmation with a biopsy because it mimics carcinoma in having nodules.
Another tip to the diagnosis |
Increased frequency of UTI in males.
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Risk factor associations with Prostate Cancer
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Age: Older
Race: Black more than white Family History: Strong influence Geography: A phenomenon of western civilization. |
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Imaging method to detect prostate cancer?
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Transrectal ultrasound guided biopsy.
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What is the gleason score based on in terms of grading prostate cancer?
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The amount of glandular differentiation and epithelial disruption of surrounding structures.
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You need to take multiple needle stick biopsies in a single case of prostate cancer because?
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Prostate cancer is heterogeneous. May be several foci with different size and histologic grade tumors.
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Occult prostate cancer is a term describing what?
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UH OH SPAGHETTIOS!
Metastatic disease to other parts of the body that were discovered for an unrelated reason (i.e. bone biopsy) without previous knowledge of prostate illness. |
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The most commonly detected stage of prostate cancer is what?
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T1C
Unpalpable but detected due to elevated PSA |
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PIN represents what?
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Prostate cancer precursor lesion.
What are the histologic clues? (4) |
Normal ducts/glands
blue color Crowded cells Macronuclei |
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Cyptorchidism is a congenital anomaly. What is it?
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Failure of testicular descent into scrotal sac. Happens mostly in premature infants.
What are the pathologic findings? |
Loss of spermatogenesis
Post-pubertal shows aggregates of immature testicular tubules. |
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What are the complications of cryptorchidism?
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Infertility
NEOPLASIA RISK!! Which neoplasm is most common? |
Seminoma in these patients.
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A kid got hit in the balls with a slapshot in a pickup roller hockey game. You're worried about what complication?
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Testicular torsion
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Many different infections are specific in their preference to affect the testes or the epidydimis.
Do you remember which two infections affect both equally? |
Malakoplakia
Fungus As a rule for the other infections remember... |
Congenital inflammatory causes (allergic, toxo, mumps,) are testicular
More interesting bugs Gonorrhea, Clamydia, TB, Scistosomiasis, Sarcoid Are epididymis. |
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Most common cancer for kids my age are testicular cancer. Common subtypes are?
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Germ cell neoplasm
Sex chord tumor *stroma* |
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Germ cell tumors in guys come in seminoma form and non seminoma. What are some characteristics other than histology that can seperate them?
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Seminomas are in the testes
NSGCT: Metastatic Seminoma: Lymphatic mets NSGCT: Blood mets also Seminoma: Radiosensitive NSGCT: Radioresistant. |
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Germ cell tumors have many markers circulating in the blood.
If HCG is elevated ONLY: If AFP is elevated ONLY If both elevated then: |
HCG only: Choriocarcionma OR Seminoma with STGC
Alphafetoprotein only: Endodermal sinus tumor AFP and HCG: Embryonal carcinoma |
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You are about to biopsy a mass from a testicle that has been removed for autopsy.
You find the mass is smooth, homogeneous with no signs of necrosis. On microscopy, the atypical cells are surrounding but not invading the seminiferous tubules. Other remarkable findings are a lymphocytic infiltrate What is this? |
Seminoma
You find it is a shame that the person died with this disease because... |
These are HIGHLY CURABLE.
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Embryonal carcinoma is different than seminoma because (2)
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Younger patients (20-30 not 40s)
AFP is elevated How does this look histologically? |
Angrier than seminoma
areas of necrosis poorly defined cell borders More large and weirder looking nuclei in the cellular infiltrate. |
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The most common testicular tumor in young children (below age 15( is what?
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Yolk Sac tumor, usually in pure form in this age.
Characteristic features are what? Three things |
Yellow/tan color myxoid contour
PAS positive SCHILLER DUVAL bodies. |
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Choriocarcinoma in males is highly malignant as it is in females.
What lab findings may suggest it? |
HCG elevation and histology shows trophoblastic cells.
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Testicular teratoma with Diploid DNA that does NOT metastesize
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Prepubertal form
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Testicular teratoma with Triploid DNA, metastatic and has genetic abnormalities
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Post-pubertal form.
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Mature teratoma is characterised by what?
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Nodularity with maybe cystic changes.
ISLANDS OF CARTILAGE Tissue resembles adult somatic tissues. |
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Term describing pre-invasive stage of germ cell tumor is what?
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Intratubular Germ Cell Neoplasm
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Staging of testicular tumor is based on location of invasion. Can you tell the stages?
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T0: Scars, no tumor
T1: Testes only T2: Invades Tunica Albuginia/epidydimis T3: Spermatic chord T4: Scrotum |
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Syphilis histology
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Plasma cell infiltrate
Endarteritis, endothelial proliferation What's the clinical picture again? |
Stage 1: Painless donut shaped chancre on genitals.
Stage 2: Diffuse rash including palms and soles Stage 3: Latent and brain invasion with neurologic defects in posterior columns. |
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Multiple penile nodules with ulcerations
Histology shows histocytes and DONOVAN BODIES |
Granuloma Inginale
Calymmatobacterium Granulomatis |
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Bilateral inguinal bubo (lymph node swelling)
Small lesions that itch |
C. Trachomatis
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Papullar rash on one dermatome that comes and goes below the belt. Vesicles are painful when present and sometimes the groin appears swollen.
Histology shows erupted vesicles and multinucleated cells with inclusions. |
Herpes Simplex II
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Molloscum
Describe the lesion |
Dome shaped papule with central dimples
Regresses in a few months. What's the histology? |
Crater like lesion with cytoplasmic inclusions
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HPV infection can appear as macules, papules, or skin tags.
What are the different serotypes? |
6,11 low risk
16,18,31,33,35,51 high risk |
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Koilocytes are a certain type of atypia that shows up in what lesion?
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Bowen's or Squamous cell in situ.
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