Male genital tract pathology a reviewer for the 3 rd practical exams
Download
1 / 73

hepatobilliary - PowerPoint PPT Presentation


  • 248 Views
  • Uploaded on

hepa

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'hepatobilliary' - guest5241


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Male genital tract pathology a reviewer for the 3 rd practical exams l.jpg

MALE GENITAL TRACT Pathology: A Reviewer for the 3rd Practical Exams

How to Use:

Identify the images on the slide. Disease names, pathognomonic lesions, and other important info that may be asked in the projection part are on the next slide.

Best viewed as a slide show


References l.jpg

REFERENCES

Lecture ppt, manual’s CD, lab (gross and histo) peekchas





Hypospadias l.jpg

Hypospadias

Abnormal urethral orifices involving the VENTRAL aspect of the penis


Epispadias l.jpg

Epispadias

Abnormal urethral orifices involving the DORSAL aspect of the penis


Phimosis l.jpg

Phimosis

Abnormally small orifice in the prepuce

Prepuce can’t be retracted


Inflammations l.jpg
INFLAMMATIONS

  • can be specific or non-specific

  • specific usually refers to sexually transmitted infections


Balanoposthisis l.jpg
Balanoposthisis

  • Non-specific infection of the glans penis and prepuce

  • Causative factors

    • Candida

    • Anaerobes

    • Gardnerella

    • Pyogenic organisms

  • Role of smegma (white exudates) – chronic accumulation account for symptom



Condyloma acuminata l.jpg
CondylomaAcuminata

  • Sexually transmitted tumor caused by human papilloma virus (HPV type 6 and 11)

  • Gross: Thrives in any moist mucocutaneous surface of the external genitalia


Condyloma acuminatum l.jpg

CondylomaAcuminatum



Condyloma acuminata19 l.jpg
CondylomaAcuminata

  • Micro: Koilocytosis or perinuclear vacuolization is the pathognomonic lesion for this disease.

  • Presence of nuclear atypia


Bowen s disease l.jpg
Bowen’s Disease

  • Involves the skin of the shaft and scrotum

  • Gross: solitary, thickened grey-white, opaque plaque; can also be seen in the glans and prepuce as single or multiple shiny red, velvety plaques.

  • Micro: surface cells are not much different from the base cells, this is defined as a “loss of maturation” pattern, and is quite typical of squamous CIS everywhere


Invasive squamous cell carcinoma l.jpg
Invasive Squamous Cell Carcinoma

  • Risk in developing penile carcinoma is related to genital hygiene since exposure to carcinogens that may be concentrated in the smegma increases the likelihood of infection which may carry the potential oncogenic type HPV 16 which is detected in 50% of patients with penile carcinoma.

  • Cigarette smoking also elevates the risk of developing penile cancer.


Infiltrating squamous cell carcinoma l.jpg

Infiltrating Squamous Cell Carcinoma

Flat lesions appear as areas of epithelial thickening accompanied by graying and fissuring of the mucosal surfacepapillary SCC




Testicular atrophy l.jpg
Testicular Atrophy

  • Atherosclerotic narrowing of the blood supply in old age

  • The end stage of an inflammatory orchitis, whatever the etiologic agent. Possible causative factors:

    • cryptorchidism

    • hypopituitarism

    • generalized malnutrition or cachexia

    • irradiation

    • prolonged administration of female sex hormones, as in treatment of patients with carcinoma of the prostate

    • Cirrhosis

  • Normal testes (left) and atrophic testes (right). In testicular atrophy, there is ghosting or fibrosis of tubules, no spermatogenesis, and increased interstitial cells of Leydig.


Testicular atrophy30 l.jpg
Testicular Atrophy

  • Ghosting or fibrosis of tubules

  • NO spermatogenesis

  • INCREASED interstitial cells of Leydig


Hydrocoele of infected testis l.jpg

Hydrocoele of infected Testis


Acute epididymitis l.jpg

Acute epididymitis

Caused by gonococcal infection

The epididymis is replaced by abcess (seen on the left side)



Torsion l.jpg
Torsion

  • Twisting of the spermatic cord which typically cuts off the venous drainage of the testis

    • Bilateral anatomic defect where the testis has increased mobility giving rise to “bell-clapper” abnormality

  • Infracted testicle and epididymis due to torsion



Seminoma l.jpg
Seminoma

  • Typical seminomas produce bulky masses, sometimes 10 times the size of a normal testis.

  • It is homogenous, gray-white in color, lobulated cut surface, usually devoid of hemorrhage or necrosis.

  • Generall, the tunica albuginea is not penetrated, but occasionally, it extends to the epididymis, spermatic cord, and scrotal sac.


Seminoma40 l.jpg
Seminoma

  • Sheets of uniform cells into poorly demarcated lobules by delicate septa of fibrous tissue.

  • Classic seminoma is large and round to polyhedral and has a distinct cell membrane, a clear or watery-appearing cytoplasm, and a large central nucleus with one or two prominent nucleoli.

  • Polygonal cells with distinct borders and clear cytoplasm due to glycogen content

  • Pathognomonic here is the lymphoid stroma.


Embryonal carcinoma l.jpg
Embryonal Carcinoma

  • Smaller than a seminoma. Does not replace the whole testis.

  • On cut surface, mass is variegated, poorly demarcated, and punctuated foci or hemorrhage or necrosis.


Embryonal carcinoma44 l.jpg
Embryonal Carcinoma

  • Cells grow in alveolar or tubular patterns, sometimes papillary convolutions

  • Undifferentiated sheets of cells may be appreciated.

  • Two cell lines: syncitio- and cyto-trophoblast

  • Syncitiotrophoblasts- bizaare looking; elaborates the tumor marker: HCG; Cytotrophoblasts- paler looking

  • Highly malignant form


Choriocarcinoma l.jpg
Choriocarcinoma

  • Highly malignant form of testicular tumor comprised of both cytotrophoblasts and syncytiotrophoblasts

  • Syncytiotrophoblast appears as a large cell having many irregular or lobular hyperchromatic nuclei and an abundant eosinophilic vacuolated cytoplasm

  • Cytotrophoblasts are more regular and polygonal with distinct borders and clear cytoplasm.


Yolk sac tumor l.jpg
Yolk Sac Tumor

  • The most common testicular tumor in infants and children up to 3 years with very good prognosis

  • Lace-like (reticular) network of medium-sized cuboidal or elongated cells.

  • Pathognomonic lesion is the presence of Schiller-Duval bodies, which resemble the primitive glomeruli and other endodermalsisuses (perivascular formation around tumor cells).



Prostatitis l.jpg
Prostatitis

  • May be acute, caused by the same pathogens as those implicated in UTI; lot of neutrophilic infiltrates

  • May be chronic, usually abacterial or from recurrent or persistent acute infections ; lymphocytic infiltration


Granulomatous prostatitis l.jpg

GranulomatousProstatitis

Can non-TB or TB-related

Escape/rupture of prostatic secretions granulomatous proliferation


Benign prostatic hyperplasia l.jpg
Benign Prostatic Hyperplasia

  • Glandular and stromal hyperplasia resulting to formation of large, fairly discrete nodules in the periurethral region of the prostate.

  • Associated with old age

  • Associated with urinary obstruction, frequency, bladder hypertrophy and bladder trabeculations

  • Micro: glandular hyperplasia. NOTE: no nucleoli


Benign prostatic hyperplasia57 l.jpg
Benign Prostatic Hyperplasia

Etiopathogenesis:

  • Androgen Related. Conversion of testosterone by enzyme type 2 5∞-reductase to DHT (dihydrotestosterone). This enzyme is located entirely on the stromal cell whereby the stromal cell is responsible for androgen-dependent prostatic growth.

  • DHT binds to androgen receptors both present on the stromal and epithelial cell; DHT serves as an indirect mitogen on prostate (stromal) cells. DHT will induce increase production of several growth factors which will increase no. of stromal cells

  • DHT does not increase cellular epithelial proliferation but instead inhibits death of the epithelial cells


Nodular hyperplasia bph l.jpg

Nodular hyperplasia, BPH

Glandular hyperplasia, no nucleoli.

dilated acini, two cell layer, cuboidal columnar




Prostatic adenocarcinoma l.jpg
Prostatic Adenocarcinoma

Prostatic carcinoma with lots of nucleoli. Presence of nucleoli distinguishes this from BPH.

Etiology

  • Androgens play an important role in prostate cancer the growth and survival of the cancer cells depend on the androgens

  • The androgens bind to the androgen receptors and induce the expression of pro-growth and pro-survival genes.


Adenocarcinoma of the prostate gland l.jpg

Adenocarcinoma of the Prostate gland


Adenocarcinoma with perineural invasion l.jpg

Adenocarcinoma with perineural invasion


Metastatic osteoblastic prostatic carcinoma l.jpg

Metastatic osteoblastic prostatic carcinoma

Within vertebral bodies

Haematogenous spread



Acknowlegdements l.jpg

We would like to thank our lecturers for their ppts. Monique and Erica for their lab pictures 

And most especially Abby, Armi, Daph, Den, Domar, FX, and Kenji for making this reviewer.

Go 2012! Study hard, work harder, party hardest 

ACKNOWLEGDEMENTS


ad