Term
| How does acquired diverticula occur in bladder? |
|
Definition
| Typically due to prostatic enlargement resulting in increased intravesical pressure and muscle thickening |
|
|
Term
|
Definition
| Developmental failure of anterior wall of bladder and abdomen. Bladder communicates with the body surface via a large defect OR exits as open sac. Can predispose to adenocarcinoma |
|
|
Term
|
Definition
| The urachus is the canal that connects the fetal bladder with the allantois. When the entire urachus is patent a fistulous urinary tract is formed connecting the bladder to the umbilicus. |
|
|
Term
| Acute vs Chronic Cystitis? |
|
Definition
Acute cystitis-Stromal edema, hemorrhage, neutrophilic infiltrate
Chronic cystitis-Lymphocytes and plasma cells |
|
|
Term
| What is Hemorrhagic cystitis and how can it be caused? |
|
Definition
Focal petechial hemorrhages can be seen in acute bacterial cystitis
Caused by cytotoxic drugs and other causes can cause extensive hemorrhagic cystitis |
|
|
Term
| In interstitial cystitis what are the symptoms? Unique ulcers? |
|
Definition
Suprapubic pain
Hematuria
Urinary frequency
Urgency
Dysuria
-You will see Hunner's Ulcers |
|
|
Term
| What is seen microscopically in Malacoplakia? |
|
Definition
| Infiltration by foamy macrophages, occasionally multinucleate giant cells, and lymphocytes. |
|
|
Term
| What is seen inside the macrophages in Malacoplakia? |
|
Definition
Michalis –Gutmann bodies can be seen in macrophages. Their cytoplasm is PAS +
These are laminates mineralized concretions due to calcium deposits in lysosomes |
|
|
Term
|
Definition
| Nests of urothelium also known as Brunn nests can grow down into the lamina propria |
|
|
Term
| What are the 2 types of Brunn Nests? |
|
Definition
Downgrowth of urothelium into lamina propria.
If central core of the nest transform into a cuboidal or columnar lining it is termed cystitis glandularis.
Cystic spaces filled with clear fluid and are lined by flattened urothelium it is called cystitis cystica |
|
|
Term
| What worsens the prognosis for urothelial tumors of the bladder? |
|
Definition
| If the tumor extends into lamina propria. It is worse when the tumor gets to muscularis propria. |
|
|
Term
| What are the risk factors for bladder cancer? |
|
Definition
-Cigarette smoking
-Industrial exposure to arylamines
-Shistosoma haematobium (Egypt and Sudan)
-Chronic use of analgesics
-Chronic exposure to cyclophosphamide |
|
|
Term
| Genetic deletion in bladder cancer? |
|
Definition
Deletion of Chromosome 9.
Imagine number 9 as bladder and penis. 9=wine, so when you drink wine you get a full bladder and pee a lot. |
|
|
Term
| What is the most significant cause of bladder obstruction in males? Females? |
|
Definition
Nodular hyperplasia of the prostate gland in males.
Bladder obstruction in females is less common and when it does occur it is most commonly secondary to cystocele of the bladder |
|
|
Term
| What 2 categories can urethritis be divided into? |
|
Definition
A.Gonococcal urethritis-Due to Neisseria gonorrhea
B.Nongonococcal urethritis-Due to a variety of bacteria including E.Coli and other enteric organisms |
|
|
Term
| What is the cellular difference between neoplasms in proximal and distal urethra. |
|
Definition
Neoplasms arising in the proximal urethra tend to have urothelial differentiation
Neoplasms in the distal urethra tend to be squamous cell carcinoma |
|
|
Term
| Malformations involving the urethral groove and urethral canal can result in opening of? |
|
Definition
The ventral surface of the penis
-This creates hypospadias
The dorsal surface of the penis
-This creates epispadias |
|
|
Term
|
Definition
| Phimosis refers to the condition in which the orifice of the prepuce is too small to allow normal retraction |
|
|
Term
| What is Paraphymosis? What can it cause? |
|
Definition
Paraphymosis refers to the condition in which a narrowed foreskin retracted over the glans cannot be put back in its normal position
It can cause venous congestion = edema and enlargement of glans. |
|
|
Term
| What is Balanoposthitis? What can cause it? |
|
Definition
Balanoposthitis is infection of the glans and prepuce. Its is secondary to a wide variety of organisms including:
Candida albicans
Anaerobic bacteria
Gardnerella
Pyogenic bacteria |
|
|
Term
| What is Bowen disease and what can cause it? |
|
Definition
| It is a carcinoma in situ of penis. Associated with HPV 16 |
|
|
Term
| What is Erythroplasia of Queyrat |
|
Definition
Erythroplasia of Queyrat is a carcinoma in situ that can occur on the glans and prepuce. It has a velvety red, well marginated appearance.
It is a form of Bowens Disease. |
|
|
Term
| What is Peyronie Disease? |
|
Definition
Peyronie disease is characterized by the involvement of the corpus cavernosum with fibrous bands
This is painful and patient has curved penis. Micro shows dense fibrosis |
|
|
Term
| What is the pampiniform plexus? |
|
Definition
| The testicular arteries are surrounded by the pampiniform plexus in which the cooler blood extracts heat from the arterial blood. |
|
|
Term
|
Definition
| Cryptorchidism refers to a complete or incomplete failure of the descent of the intrabdominal testes into the scrotal sac |
|
|
Term
| Epididymitis with possible subsequent orchitis occurs how? |
|
Definition
| 2ndary to bacterial infection. It gains access to epididymis and testis through the vas deferens or lymphatics in spermatic cord |
|
|
Term
| What are the causes of epididymitis in: A) Children B) Adults <35 C) Adults > 35? |
|
Definition
Childhood: genitourinary abnormalities and gram negative rods
Adults <35 years of age: C. trachomatis
Neisseria gonorrhea
Men > 35 years of age
Common urinary tract pathogens such as E. coli and Pseudomonas |
|
|
Term
| What do Testicular Germ Cell Neoplasms (Seminoma) arise from? Chromosome? |
|
Definition
Most of the testicular germ cell neoplasms arise from lesions called intratubular germ cell neoplasia (ITGCN)
-Have an isochromosome 12p |
|
|
Term
| What do Seminomas stain positive for? |
|
Definition
| Positive staining for c-kit,OCT-4, and placental alkaline phosphatase (PLAP) |
|
|
Term
| Age distribution between seminoma and Spermatocytic Seminoma? |
|
Definition
Seminomap 15-34
Spermatocytic Seminoma- >65 |
|
|
Term
| What germ cell tumor has sheets of undifferentiated cells with large nuclei that are hyperchromatic? |
|
Definition
|
|
Term
| Most common tumor in infants and children up to 3 years of age |
|
Definition
| Yolk Sac Tumor aka Endodermal Sinus Tumor |
|
|
Term
| What are Schiller-Duval bodies? |
|
Definition
| Seen in Yolk Sac tumor. Mesodermal core with a central capillary and a visceral and parietal layer of cells which looks like a glomerulus |
|
|
Term
| What does a Yolk Sac Tumor stain + for? |
|
Definition
| Alpha Fetoprotein and alpha-1 antitrypsin |
|
|
Term
What has cytotrophoblast cells
and syncytiotrophoblasts? Describe the cells |
|
Definition
Choriocarcinoma
Syncytiotrophoblast cells
-Large
-Many irregular/lobular hyperchromatic nuclei
-Abundant eosinophilic vacuolated cytoplasm
-HCG can be detected in the cytoplasm
Cytotrophoblastic cell
-Tend to be polygonal
-Distinct borders
-Uniform nucleus
-Grow in cords/masses |
|
|
Term
| A group of testicular tumors that consist of various cellular and organoid component that look like normal derivatives from more than one germ layer |
|
Definition
|
|
Term
| In lymphatic spread of testicular tumor, what are the first lymphatics affected? |
|
Definition
| Retroperitoneal para-aortic nodes |
|
|
Term
| Where do testicular tumors most likely metastasize to? |
|
Definition
|
|
Term
| What markers are seen with what germ cell tumors? |
|
Definition
1.Lactate dehydrogenase correlates with tumor cell mass
2.AFP can be seen in yolk sac tumor elements
3. HCG can be seen in choriocarcinoma elements
AFP and HCG are seen in 80% of NSGCT at the time of diagnosis |
|
|
Term
|
Definition
Rod shaped eosinophilic cytoplasmic inclusions can be seen in 25%of tumors
(Leydig). Can also be seen in normal postpubescent testis |
|
|
Term
| How does Sertoli Cell Tumor look microscopically? |
|
Definition
| The tumor cells are arranged as trabeculae forming cordlike structures and tubules |
|
|
Term
|
Definition
| Collection of serous fluid in the tunica vaginalis |
|
|
Term
| Most common cause in USA of Granulomatous Prostatitis? |
|
Definition
| BCG is an attenuated strain of mycobacteria |
|
|
Term
|
Definition
| by hyperplasia of the prostatic stromal and epithelial cells |
|
|
Term
| Where does nodular hyperplasia of the prostate form? |
|
Definition
| The inner aspect of the prostate also known as the transition zone |
|
|
Term
| Most common epigenetic alteration of prostate cancer? |
|
Definition
| Hypermethylation of glutathione S-transferase (GSTP-1). It prevents damage from various carcinogens |
|
|
Term
| What fibrous disease can cause hydronephrosis? |
|
Definition
Sclerosing Retroperitoneal Fibrosis
This is a disorder characterized by a fibrous proliferative inflammatory process that encases the retroperitoneal structures resulting in hydronephrosis |
|
|
Term
|
Definition
|
|
Term
|
Definition
Interstitial Cystitis
The hemorrhagic defect is known as a Hunner ulcer |
|
|
Term
|
Definition
Malacoplakia Cystitis
The top picture shows a bladder with broad flat plaques.
The bottom image is shows macrophages with granular PAS positive cytoplasm. Note the round Michaelis-Gutman bodies surrounded by the clear zones. |
|
|
Term
|
Definition
Nephrogenic adenoma (metaplasia).Note the aggregates of cuboidal cells forming small tubules within the lamina propria
The overlying epithelium can be replaced by cuboidal epithelium and may develop a papillary growth pattern |
|
|
Term
|
Definition
Bladder.
The upper section shows a large papillary tumor
The lower section shows multifocal and smaller papillary neoplasms |
|
|
Term
|
Definition
Paraphimosis
The foreskin is retracted proximal to the glans penis and is markedly swollen secondary to venous congestion |
|
|
Term
|
Definition
| Phimosis. The foreskin has been chronically inflamed and is no longer retractable over the glans |
|
|
Term
|
Definition
Seminoma
Note the well-circumscribed, pale ,fleshy, homogenous mass |
|
|
Term
|
Definition
Embryonal Carcinoma
Note the hemorrhagic appearance
Note the sheets of undifferentiated cells. The nuclei are large and hyperchromatic. |
|
|
Term
|
Definition
| Yolk sac tumor. Note the strands of epithelial cells surrounded by loose connective tissue. The arrow is indicating a glomeruloid structure (Schiller-Duval body) |
|
|
Term
|
Definition
Choriocarcinoma.
The arrowhead is indicating cytotrophoblast cells
The arrow is showing syncytiotrophoblasts. Note the multiple dark nuclei within the eosinophilic cytoplasm |
|
|
Term
|
Definition
Teratoma
Note the variegated cut surface and cysts. This reflects the various tissues |
|
|
Term
|
Definition
Teratoma of testis.
Note the collection of glands,cartilage, smooth muscle, and immature stroma. |
|
|
Term
|
Definition
| Leydig cell tumor. Note the uniform and round nuclei and eosinophilic cytoplasm. The arrow is indicating 3 Reinke crystals |
|
|
Term
|
Definition
| Sertoli cell tumor. Notice how the structures look like seminiferous tubules without germ cells |
|
|
Term
|
Definition
Benign Prostatic Hyperplasia
Nodular prostatic hyperplasia
Notice the well defined nodules. There is also compression of the urethra
Notice the nodules of hyperplastic tissue
The glands are composed of 2 layers of cells. The inner cell is columnar and the outer cell is flattened. |
|
|
Term
|
Definition
Adenocarcinoma of the prostate
In the image directly above notice the solid and whiter tissue in the lower left portion of the image. This represents the gross manifestation of prostate cancer
In figure A (above left) notice the smaller glands located between normal glands
In figure B (below left) notice the enlarged nuclei, prominent nucleoli, and darker cytoplasm as compared with the benign gland at the top of the picture. |
|
|
