Specific Pathology 01: Male Genital

Front 1

2 kinds of testicular tumors

Back 1

germ cell
non-germinal

Front 2

___% of testicular tumors are germ cell. they are the most common tumor in men aged ___. mortality is ___%

Back 2

90
15-34
10

Front 3

2 categories of germ cell tumors

Back 3

single histological pattern
mixed histological pattern

Front 4

___% of germ cell tumors have a single histological pattern

Back 4

40

Front 5

the precancerous condition predisposing to GCT is

Back 5

intratubular germ cell neoplasia (ITGCN)

Front 6

___% of untreated ITGCN progresses to cancer

Back 6

50

Front 7

risk factors for ITGCN (4)

Back 7

cryptorchidism
family history
androgen insensitivity
gonadal dysgenesis

Front 8

cryptorchidism causes ___ of seminiferous tubules, leaving only ___ preserved. it causes a relative increase of ___

Back 8

atrophy
sertoli cells
leydig cells

Front 9

___% of GCT is associated with cryptorchidism

Back 9

10

Front 10

the lower the testis has descended the ___ the risk of cancer

Back 10

lower

Front 11

___ is a chromosomal abnormality found in almost all GCTs.

Back 11

isochromosome of short arm of 12

Front 12

classic seminomas are positive for

Back 12

PLAP
c-Kit (CD117)
OCT3/4

Front 13

in contrast to classic seminomas, spermatocytic seminomas ___

Back 13

are negative for PLAP, OCT3/4

Front 14

compared to seminomas, embryonal carcinomas are ___ (2)

Back 14

much more aggressive
smaller

Front 15

T/F: embryonal carcinomas never extend to epididymis or beyond

Back 15

false

Front 16

histological formations in embryonal carcinoma

Back 16

undifferentiated
tubular
papillary

Front 17

syncitiotrophoblast may be present in ___ (3)

Back 17

seminoma
embryonal carcinoma
choriocarcinoma

Front 18

markers in embryonal carcinoma (4)

Back 18

PLAP
OCT3/4
CD30
cytokeratin

Front 19

OCT3/4 is a ___ expressed in ___ (3)

Back 19

transcription factor
primordial germ cells
seminomas
embryonal carcinomas

Front 20

___ is the most common tumor in children under 3

Back 20

yolk sac tumor

Front 21

in children, yolk sac tumors have ___ prognosis

Back 21

good

Front 22

in adults yolk sac tumors occur in the context of ___

Back 22

mixed tumor with embyronal carcinoma

Front 23

histologically, yolk sac tumors have a ___ pattern

Back 23

microcystic

Front 24

___% of yolk sac tumors have ___ bodies, which feature ____ epithelia as found in ___. ___ globules are also present

Back 24

50
Schiller-Duval
parietal and visceral
glomeruli
hyaline

Front 25

markers for yolk sac tumor

Back 25

AFP
cytokeratin
PLAP

Front 26

choriocarcinoma is ___ in testes and ___ in ovaries

Back 26

rare
more common

Front 27

choriocarcinoma is usually found as ___

Back 27

foci in mixed tumor

Front 28

markers for choriocarcinoma

Back 28

hCG
cytokeratin
PLAP

Front 29

in children, ___ teratomas are benign for males and ___ teratomas are benign for femals. in adults, ___ teratomas are malignant

Back 29

all
mature
all

Front 30

common mixed tumors (3)

Back 30

embryonal carcinoma + seminoma
embryonal carcinoma + teratoma
embryonal carcinoma + teratoma + yolk sac

Front 31

prognosis in mixed GCTs depends on

Back 31

presence of aggressive tumor types

Front 32

T/F: seminoma has much better prognosis than nonseminoma

Back 32

true

Front 33

lymphatic metastases from GCTs go to ___ (3)

Back 33

retroperitoneal para-aortic LN
mediastinal LN
subclavicular LN

Front 34

hematogenous metastases from GCTs go to ___ (4)

Back 34

lungs
liver
brain
bones

Front 35

T/F: histology of metastases is the same as the primary tumor

Back 35

false

Front 36

seminomas spread primarily through ___

Back 36

lymphatics

Front 37

nonseminomas spread primarily through ___

Back 37

blood and lymphatics

Front 38

BPH happens at the ___ zone, aka ___, located ___. This explains ___.

Back 38

transition
urethral prostate
where urethra enters from bladder
rapid urinary symptoms

Front 39

Tumors develop at the ___ zone, located ___. ___ is used to detect them.

Back 39

peripheral
dorsally and away from urethra
PSA

Front 40

BPH is hyperplasia of ___ (2). It is caused by ___, which is made in ___.

Back 40

epithelium
stroma
DHT
stroma

Front 41

___% of those with BPH have symptoms

Back 41

50

Front 42

DHT is ___ times more potent than testosterone, because ___.

Back 42

10
higher receptor affinity

Front 43

BPH can present as ___ or ___

Back 43

fibromuscular nodules
epithelial nodules

Front 44

in BPH, ___ is preserved

Back 44

basal layer

Front 45

T/F: BPH can be diagnosed on the basis of needle biopsy.

Back 45

false

Front 46

___ is the most common cancer in men

Back 46

prostatic adenocarcinoma

Front 47

prostatic adenocarcinoma is the ___ most lethal cancer in men

Back 47

2nd

Front 48

___% of men age 50-59 have asymptomatic prostatic adenocarcinoma, and ___% of men age 70-80

Back 48

20
70

Front 49

susceptibility genes for PCa are located on chromosome ___. tumor suppressor genes commonly downregulated are located on chromosmes ___ (4)

Back 49

1
8
10
13
16

Front 50

T/F: p53 is commonly inactivated in early stage of PCa.

Back 50

false

Front 51

T/F: Her2/Neu is not commonly overexpressed in PCa

Back 51

true

Front 52

using ___ technology, the genes overexpressed in PCa were found to be ___ (2)

Back 52

cDNA microarray
hepsin
alpha-methyl acyl CoA racemase (p504)

Front 53

hepsin is a ___

Back 53

transmembrane Ser protease

Front 54

a gene commonly suppressed in PCa is ___. suppression occurs via ___

Back 54

glutathione S transferase (GSTP1)
hypermethylation of promoter

Front 55

glands in PCa are ___ with ___ layers of ___ or ___ epithelium

Back 55

small
1
cuboidal
columnar

Front 56

T/F glands in PCa are pleomorphic with mitotic figures

Back 56

false

Front 57

the most important feature in diagnosing PCa is ___

Back 57

absence of basal cells

Front 58

a positive marker for PCa is ___

Back 58

p504

Front 59

immunostains for basal cells label ___

Back 59

keratin

Front 60

gleason scores range from ___ to ___

Back 60

2
10

Front 61

gleason scores of less than 4 have a ___% probability of progression, 5--7 have a ___% probability, and >7 have a __% probability

Back 61

25
50
75

Front 62

the precursor lesion for PCa is called ___. it is present in ___% of tissue removed for PCa biopsy

Back 62

prostatic intraepithelial neoplasia (PIN)
80

Front 63

in PIN, ___ is preserved

Back 63

basal layer

Front 64

in stage II, PCa is present in ___, but in stage III it may be present in ___ (2) also
in stage IV it may be present in ___ (3)

Back 64

prostate
bladder
seminal vesicles
colon
pubis
other organs

Front 65

PCa spreads by ___ (3)

Back 65

direct local invasion
hematogenous spread
lymphatic spread

Front 66

PCa spreads hematogenously to ___, specificially ___ (5)

Back 66

bone
lumbar spine
proximal femur
pelvis
thoracic spine
ribs

Front 67

PCa spreads lymphatically to ___ (6)

Back 67

obturator LNs
perivseical LNs
hypogastric LNs
iliac LNs
presacral LNs
paraaortic LNs

Front 68

PCa bone metastases are usually ___

Back 68

osteoblastic