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100 Cards in this Set
- Front
- Back
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What is this congenital disease?
- abnormal opening on ventral surface of urethral groove - associated with failure of descent of testes - urinary tract obstruction, infections, sterility |
Hypospadias
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What is this congenital disease?
- abnormal opening on dorsal surface of urethral groove - associated with failure of descent of testes - urinary tract obstruction, infections, sterility |
Epispadias
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What is this disease?
- orifice of the prepuce is too small to permit normal retraction |
Phimosis
- congenital - acquired: repeated infections with secondary fibrosis |
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What are some complications of phimosis?
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- secondary infections
- carcinoma of penis - paraphimosis: constriction of prepuce around penis with swelling and edema, preventing its replacement over the glans |
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What is paraphimosis? what might cause this?
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Paraphimosis: constriction of prepuce around penis with swelling and edema, preventing its replacement over the glans
- it is a complication of phimosis (orifice of the prepuce is too small to permit its normal retraction) |
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Inflammation of the glans and prepuce is called ____.
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balanoposthitis
- simple - erosive - gangrenous - atrophic leukoplakic - herpes simplex |
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Predisposing factors of balanosphthitis.
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- lack of circumcision
- poor hygiene - phimosis |
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What is this disease?
- lymphocytes and plasma cells infiltrating the dermis - reactive epidermal hyperplasia |
balanoposthitis
- lack of circumcision - poor hygiene - phimosis |
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What is this lesion?
- hyperplastic epithelium with hyperkeratosis and acanthosis - branching connective tissue stroma - koilocytotic changes in squamous cell nuclei (perinuclear vacuoles and raisinoid) |
condyloma acuminatum
- HPV 6 often - located on moist mucocutaneous surfaces of external genitalia |
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What are these abnormal cells called? what disease is it associated with?
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koilocytes
- condyloma acuminatum (HPV6) |
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What are thest abnormal cell called? what disease is it associated with?
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koilocyte (raisinoid): enlarged hyperchromatic nuclei with irregular membranes
- associated with condyloma accuminatum (HPV6) |
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What skin disease does each of the following cause?
- HPV6 - HPV16 |
- HPV6: condyloma acuminatum
- HPV16: squamous cell carcinoma in situ |
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What do the following share in common?
- Bowen disease - erythroplasia of Queyrat - bowenoid papulosis |
they are three distinct forms of squamous carcinoma in situ, but share same histo features
- full thickness of dysplasia of squamous epithelium - disordered maturation - marked nuclear pleomorphism - basement membrane intact |
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What is this disease?
gross - solitary gray-white plaque on skin of penis or scrotum Micro - full thickness dysplasia of squamous epithelium - basement membrane intact |
Bowen disease (CIS)
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What is this disease?
gross - shiny, red velvety plaques on penis and prepuce Micro - full thickness dysplasia of squamous epithelium - basement membrane intact |
erythroplasia oif Queyrat
- histo the same as Bowen's |
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What is this disease?
gross - multiple red-brown papules, some verrucous Micro - full thickness dysplasia of squamous epithelium - basement membrane intact |
Bowenoid papulosis
- histo is the same as Bowen's |
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What is this tumor?
- 1% of male carcinomas in U.S. - begins on glans or inner surface of prepuce |
invasive squamous carcinoma (HPV16, 18)
- ulcerated flat lesion or exophytic papillary lesion |
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What is the prognosis of invasive carcinoma of penis?
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- slow growing, metastasize to inguinal and iliac lymph nodes
- if no lymph node involvement: 66% 5 yr survival - if lymph node involvement: 27% 5 yr survival |
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What are some causes of epididymitis in children?
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- congenital anomalies
- GNB |
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What are some causes of epididymitis in sexually active men?
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- chlamydia
- gonorrhea |
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What are some causes of epididymitis in older men?
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- urinary tract pathogens (E. coli, pseudomonas)
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What is this disease?
micro - inflammation with variable fibrosis |
epidydimitis
- gonorrhea (supprative): acute - TB (granulomatous): chronic |
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Sequelae of epidydimitis.
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- abscess formation
- sterility |
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What are some causes of orchitis (inflammation of the testes)?
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- mumps: school aged children, one week after parotid gland swelling
- syphilis: affect testes first then epidydimis - TB: affect epidydimis first then testes - gonorrhea: only in untreated cases |
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What is the cause of this?
- school aged children deveoped lumpy jaw - a week later developed orchitis |
mumps
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What is the cause of this?
- orchitis first, then epidydimitis |
syphilis
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What is the cause of this?
- epidydimitis first, then orchitis |
TB
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Pathogenesis of torsion of testes.
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venous outflow from testes cut off -> marked congestion -> hemorrhage, infarction (if not treated)
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Who are more prone to get torsion of testis?
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- incomplete descent of testes
- absent scrotal ligaments - atrophy of testis 9more mobile) |
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What is another name for undescended testes?
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cryptorchidism
- 1% of 1 yr old boys - often palpable in inguinal canal - 75% unilateral |
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Pathogenesis of cryptorchidism.
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- failure of intra-abdominal testes to descend to scrotum
- deficient LH-RH - trisomy 13 - other UG anomalies |
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Sequelae of crytorchidism.
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- progressive tubular atrophy: decreased germ cells, infertility
- increased risk of neoplasm: 5x-10x, orchiopexy (surgical placement of testes in scrotum) can decrease the risk |
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What is sequelae of crytorchidism called?
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tubular atrophy
- sertoli cells only - thickened basement membrane |
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Germ cell or sex cord stromal neopalsm of testes?
- malignant - 95% of all neoplasms of testes - cured with surgery + chemo |
germ cell tumors
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Germ cell or sex cord stromal neopalsm of testes?
- benign - 5% of all neoplasms of testes - cured with excision - may secrete hormones |
sex cord stromal tumors
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What is the main predisposing factor of germ cell neoplasms of testes?
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crytorchidism
others - genetic (familial clustering) - testicular dysgenesis (testicular geminization XY with androgen insensitivity, Klinefelter syndrome 47XXY) |
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What are the two types of germ cell neoplasms of testes?
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1) seminoma
2) non-seminoma - embryonal carcinoma - yolk sac tumor: AFP positive - choriocarcinoma: hCG positive - teratoma |
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When is the peak incidence of germ cell tumor of testes?
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age 15-34
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Is germ cell tumor more prevalent in whites or blacks?
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whites
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What is the origin of germ cell tumors?
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intratubular multipotential germ cells
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What is the most common germ cell tumor?
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seminoma
- postpubertal males, incidence peaks in 30s - histologically similar to ovarian dysgerminoma |
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What are the three histologic subtypes of seminoma?
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- typical (85%): placental alkaline posphatase +
- anaplastic (5-10%): pelomorphic cells, > 3 mitoses/hpf - spermatocytic (5%): three intermixed cell populations |
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What is this disease?
Gross - bulky, replaces entire testes - confined within tunica albuginea - lobulated surface - little hemorrhage or necrosis |
seminoma
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What is this disease?
Micro - sheets of uniform cells divided by thin septae of fibrous tissue - large distinct cell borders with lots of cytoplasm (glycogen) - scattered reactive lymphocytes |
seminoma
- APF - - hCG -, 15% seminomas contain syncytiotrohpoblastic giant cells that secretes hCG |
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What is this disease?
Micro - 3 mixed cell populations showing features of spermatocytes by EM |
Spermatocytic seminoma
- older men (>age65) |
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What germ cell tumor is this?
- poorly demarcated - zones of hemorrhage and necrosis |
embryonal carcinoma
- AFP - - hcG - |
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What germ cell tumor is this?
- solid syncytial sheets - glandular or tubular patterns - large anaplastic cells with scattered tumor giant cells - indistinct cell borders - frequent mitoses |
embryonal carcinoma
- AFP - - hCG - |
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What is the most common testicular tumor in children < 3?
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yolk sac tumor (endometrial sinus tumor)
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What is this testicular cancer?
- AFP + - alpha-antitrpysin + |
yolk sac tumor
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What is this testicular cancer?
- hCG + |
choriocarcinoma
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What is this testicular cancer?
- endodermal sinuses (core with central capillary, covered by visceral and parietal cells, resemble primitive glomerulus) - hyaline globules |
yolk sac tumor
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What is this testicular cancer?
- endodermal sinuses (core with central capillary, covered by visceral and parietal cells, resemble primitive glomerulus) - hyaline globules |
yolk sac tumor
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What is this testicular cancer?
- composed of both cytotrophoblasts and syncytiotrophoblasts - aggressive, produce hemorrhage and necrosis - hCG + |
choriocarcinoma
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What is this testicular cancer?
- germ cell tumor containing elements from more than one embryonic layer - gross: heterogeneous texture with solid and cystic areas |
teratoma
- pure form mainly in children |
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Which of the three vaiants of teratoma?
- all elements differentiated: mature epithelial, connective, neural cells) |
mature teratoma
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Which of the three vaiants of teratoma?
- incomplete differentiation - primitive mesechymal cells, neuroblasts, etc |
immature teratoma
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Which of the three vaiants of teratoma?
- mainly differentiated cells - one mature component transformed into malignancy |
teratoma with malignant transformation
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Seminoma vs. non-seminoma.
- usually stage 2 and 3 at diagnosis - metastaze to lymph nodes - radiosensitive - good prognosis |
seminoma
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Seminoma vs. non-seminoma.
- usually stage 1 at diagnosis - metastaze early by hematogenous route - radioresistant - aggressive |
non-seminoma
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Which stage os testicular cancer is this?
- tumor confined to testis, epidydimis or spermatic cord |
stage 1
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Which stage os testicular cancer is this?
- distant metastases confined to retroperitoneal nodes below diaphragm |
stage 2
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Which stage os testicular cancer is this?
- metastasize outside the retroperitoneal nodes or above the diaphragm |
stage 3
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What testicular cancer is this?
- precocious children or gynecomastia in adults - 90% benign |
sex cord stromal tumor - leydig cell tunor
- polygonal cells with red cytoplasm containing rod like crystalloids of Reinke |
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What testicular tumor is this?
- secrete estrogens or androgens - no clinical endocrine symptoms - tendency to form immature seminiferous tubules - 90% benign |
sex cord stromal tumor - sertoli cell tumor (androblastoma)
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What is this testicular tumor?
- most common testicular cancer in men >60 - poor prognosis |
malignant lymphoma of testis
- diffuse large B cell |
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What are the 4 histologic zones of normal prostate?
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- central (CZ)
- peripheral (PZ) - transitional (TZ) - periurethral |
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Describe the lining of normal prostate gland.
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2 layers of epithelium
- flat basal cells - columnar secretory cells |
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Etiology of prostatitis?
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- bacterial: GNB (E.coli)
- chronic abacterial: culture - |
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What is the cause of this prostitis?
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TB or sterile
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Nodular prostate hyperplasia originate from which 2 of the 4 histologic zones?
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- transitional
- periurethral |
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How does nodular prostate hyperplasia look histologically?
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- glandular hyperplasia: cystic dilation, papillary budding
- stromal hyperplasia: fibromuscular - 2 layers of epithelium preserved |
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These are symptoms of which prostate disease?
- difficulty urinate - urine retention, bladder distention, risk of infection - difficulty start and stop urine stream - nocturia, dysuria |
nodular hyperplasia
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What is the most common cancer in U.S. men?
What is the most common cause of cancer death in US men? |
- prostate cancer
- lung cancer #1, prostate cancer #2 |
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Who has higher incidence of prostate cancer? (african americans or caucasians)
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African Americans:
- shortest CAG repeats make prostate epithelium more sensitive to androgen. |
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What is this called?
asymptomatic prostate cancer discovered at autopsy or removed sugically for treatment of benign prostatic hypertrophy. |
latent prostate cancer
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What is the current NIH dietary recommendation on prostate cancer prevention?
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multiple servings of fruit and vegetables each day.
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Patterns of spread of prostatic carcinoma.
- into seminal vesicles, base of bladder |
direct extension
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Patterns of spread of prostatic carcinoma.
- obturator, iliac, perivesical, hypogastric nodes |
lymphatic
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Patterns of spread of prostatic carcinoma.
- to bones, visceral organs (less likely) |
hematongenous
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What is this tumor?
Micro - haphazardly distributed neoplastic glands invading fibromuscular stroma |
prostate carcinoma
- nearly all are adenocarcinoma - malignant glands often crowded tighly together and usually are usually smaller |
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What is this tumor?
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prostate carcinoma
- single layer of epithelium (basal layer absent) - enlarged nuclei with prominent nucleoli - mitoses uncommon - red "crystalloids" |
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This is a complication of what tumor?
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Perineural invasion
- a complication of invasive prostate cancer |
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Which Gleason grading score is prostate cancer?
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Gleason 3
- small and medium sized glands - glands are separated by stroma |
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Which Gleason grading score is prostate cancer?
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Gleason 4
- small glands fused together into solid aggregates without intervening stroma |
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Which TNM stage is this prostate cancer?
- cancer incidentally found by TURP or needle biopsy in <5% of tissue fragments |
T1a
- treatment unnecessary - 95% 10 yr survival |
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Which TNM stage is this prostate cancer?
- cancer incidentally found by TURP or needle biopsy in >5% of tissue fragments |
T1b
- 80% 10 yr survival |
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Which TNM stage is this prostate cancer?
- cancer confined within prostate |
T2
- 80% 10 yr survival |
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Which TNM stage is this prostate cancer?
- cancer invade outside prostate |
T3a
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Which TNM stage is this prostate cancer?
- cancer invades outsidde prostate with seminal vesicle involvement |
T3b
- 60% 10 yr survival |
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Which TNM stage is this prostate cancer?
- cancer directly invades contiguous organs |
T4
- incurable - 10%-40% 10 yr survival |
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What is tumor?
- precursor of prostate carcinoma - preserved basal cell layer and intact basement membrane |
PIN
- dysplastic columnar cells with nucleomegaly and prominent nucleoli - IHS for anti-cytokeratin antibody |
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What is this tumor?
- immunohistologic stain positive for anti-cytokeratin antibody |
PIN
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What is the most common bacterial STD worldwide?
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chlamydia
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Which stage of syphilis is this?
- painless chancre 3 wks after contact (organism already spread through body by lymph and blood) |
stage 1
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Which stage of syphilis is this?
- maculopapular scaly rash on palms and soles - condyloma lata (broad raised plaques in anogenital, inguinal and axillary region) - gray superficial erosions on mucous membrames (mouth, pharynx, genitalia) - lymphadenopathy |
stage 2
- 2-10 wks after chancre |
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Which stage of syphilis is this?
- aorititis: dilation of aortic root and arch, aortic insufficiency and aneurysms - neurosyphilis: tabes dorsalis, general paresis - gummas: nodular sites of delayed hypersensitivity to bacteria in bone, skin, mucous membranes |
stage 3
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What is the cause of this?
- ulcerative STD - painful ulcers 4-7 days after contact - regiional adenopathy (buboes) |
chancroid (hemophilus ducreyi)
- most prevalent in tropics |
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What is the disease?
- lymphedema (elephatiasis) - extensive scarring of external genitalia - biopsy showed "Donovan bodies": encapsulated coccobacilli within macrohoages and neutrophils |
Granuloma inguinale
- klebsiella (GNB) |
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What is the cause?
- pruritic dermatosis - linear streaks on skin of hands, wrists, genital area |
scabies
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What is the cause?
- pruritic lesions in pubic region - louse or eggs become attached to hair shafts after sexual contact |
pediculosis
- phthruis pubis |
