Pathology 1 - Final - Part 1

davidwurbel7's version from 2016-04-08 20:06


Question Answer
Vestigial structure. connects bladder with allantois. eventually becomes median umbilical ligament. persistence lead to clinical featuresUrachus
Clinical features include sinus, fistula, diverticulum. Drainage from umbilicus, redness around umbilicus. Risk of cancer (adenocarcinoma bladder)Urachus
Developmental failure of anterior wall of abdomen wall, and bladder. Bladder then communicates directly through a large defect or appears as an opened sac. Clinical Importance: colonic glandular metaplasia. risk of adenocarcinomaBladder Exstrophy
Development in patients receiving cyclophosphamide or ifosfamide. Both drugs are metabolized to acrolein, which is a strong chemical irritant that is excreted in the urineHemorrhagic cystitis
Clinical features frequency, lower abdominal pain, dysuria, hematuria and risk of cancer. Morphology includes edema, hyperemia, mucosal ulcerationHemorrhagic cystitis
Associated with long standing cystitis, irritation. nests of urothelium (Brunn nests) grow downward into lamina propria and undergo transformation into cuboidal/columnar epithelium forming cystic spaces. mostly seen in trigone areaCystitis Glandularis
Associated with long standing cystitis, irritation. nests of urothelium (Brunn nests) grow downward into lamina propria and undergo transformation forming cystic spaces filled with clear fluid lined by flattened urothelium. Both patterns may exist together. mostly seen in trigone area. mostly seen in trigone areaCystitis Cystica
Due to chronic inflammatory reaction. seen in setting of bacterial infections: E. coli, Proteus. higher association with immuno-compromised patientsMalakoplakia
Laminated mineralized concretions from calcium depositions in enlarged lysosomesMichaelis-Gutmann Bodies
Chronic inflammation. Soft, yellow, slightly raised plaques. large, foamy macrophages, occasional multi-nucleate giant cells. Michaelis-Gutmann bodies can be seenMalakoplakia
More common in Egypt, Western Europe, USA. more in men, risk increases with age, 20% increase. smoking, occupational exposure to carcinogens (beta naphtylamine used as dyes, rubber industry). parasitic infection - Schistosoma hematobium. Drugs: phenacetin, cyclophosphamide therapy radiation. Chemicals: arsenicBladder Cancer
Mutation mostly noted in non-invasive low grade papillary carcinoma of the bladderFGFR3 and H RAS Mutations
Mutation mostly seen with high-grade tumors with muscle invasionp53, and RB Gene Mutations
Elevated lesions, multiple. Field defect: entire bladder lining affected. This leads to multicenteric tumor formation. Papillary lesions contain finger-like papillae with central core of loose fibrovascular tissueTransitional Cell Carcinoma
Clinical Features include painless hematuria, urgency, dysuria (irritative voiding), obstruction of ureteral orifice may lead to pyelonephritis, hydronephrosis. Once hematuria is documented, a urinary cytology, visualization of the urothelial tract by CT or intravenous pyelogram, and cystoscopy are recommendedBladder Cancer
Benign hamartoma seen most often bilaterally in adults with Tuberous sclerosis. composed of thick walled blood vessels, muscle fibers, and adipose. Clinical features include may lead to spontaneous retroperitoneal hemorrhageAngiomyolipoma
Incidence - 6th to 7th decade of life. More in males. Incidence of RCC has been increasing over the last several decades. Smoking and Diet are risk factorsRenal Cell Carcinoma
Single tumor, upper pole, smoking. Seen in 6th or 7th decade of lifeSporadic Renal Cell Carcinoma
Usually bilateral tumors. Seen in von Hippel Lindau syndrome. multiple, bilateral. Seen in 5th or 6th decade of lifeHereditary Renal Cell Carcinoma
Is the most common, 70 to 80% of renal cell cancers. Tumor cells show clear cytoplasm. Both Sporadic and Hereditary types are associated with VHL gene (chromosome 3). Leads to increased IGF-1. This leads to dysregulation of hypoxia inducible factor. HIF increases production of VEG and PDGF. These then promote angiogenesis and growth of the tumorClear Cell Carcinoma
Typically show yellow solid areas with hemorrhage. Tend to be located on upper pole, single, and unilateralSporadic Renal Cell Carcinoma
Clinical features include triad: painless hematuria, costovertebral pain, palpable mass. invasion of IVC. left-sided varicocele due to obstruction of left testicular vein. Para neoplastic syndrome - Erythropoietin (polycythemia), PTHrP (hypercalcemia), and ACTH (Cushing syndrome)Renal Cell Carcinoma
Renal malignancy, pediatric age group, less than 10 years of age. Arises from persistent embryonal renal cells (blastema)Wilms Tumor
Characterized by Wilms tumor, aniridia, genital anomalies, and mental retardationWAGR Syndrome (WT1)
Characterized by gonadal dysgenesis (male pseudohermaphroditism)Denys-Drash Syndrome
Characterized by enlargement of body organs (organomegaly), macroglossia, hemihypertrophy, omphalocele, and abnormal large cells in the adrenal cortex (adrenal cytomegaly)Beckwith-Wiedemann Syndrome
5 to 10% are bilateral. histogenesis: nephrogenic rests. On histology: triphasic (epithelial, stromal, and blastemal)Wilms Tumor
Clinical features include large abdominal mass. may extend across the midline and down into the pelvis. hematuria, pain in the abdomen. hypertension. good prognosisWilms Tumor
Pelvic discomfort greater than 3 months with or without pyuria and negative prostate or urinary tract culturesChronic Pelvic Pain Syndrome
Clinical features include hesitancy, decreased force and caliber of stream, sensation of incomplete bladder emptying, double voiding, straining to urinate, and postvoid dribbling. Urgency, frequency, and nocturia, infectionBenign Prostatic Hyperplasia
Age (older), diet/lifestyle (high-saturated fat diet, red meat, low processed tomatoes may be protective (lycopenes). African Americans have a higher frequency of death from prostate cancer compared to Caucasian and Asians. BRCA2: germline mutation. Metastasis to the bone is osteoblastic in natureProstatic Adenocarcinoma

Male Genital System

Question Answer
Sexually transmitted disease. Associated with HPV 6 and 11. Presents as a warty growth from external genitalia and anusCondyloma Acuminatum
Single/multiple sessile or pedunculated. red papillary excrescences. koilocytosis seen on microscopy. Clinical course - lesions seen on coronal sulcus, and prepuce. tend to recur. rarely progress to malignancyCondyloma Acuminatum
Usually seen above 35 years of age (typically over 60 yrs). presents as solitary grey-white thickened plaque. involves shaft of penis, and scrotum. squamous cell carcinoma in-situ. associated with HPV 16. has the potential to progress to invasive squamous cell carcinomaBowen Disease
Carcinoma in situ. epidermal proliferation. numerous mitosis. atypical mitosis, dysplastic. intact BM. Clinical Importance - risk of transformation into invasive squamous cell carcinomaBowen Disease
Seen in sexually active males. usually younger age. multiple lesions. Micro - carcinoma in situ. similar to Bowen disease. linked to HPV 16. Clinical Importance - does not transform to invasive carcinomaBowenoid Papulosis
Presents as bright red, shiny patches, or plaques of the mucosal sites, the glans, and prepuce of the uncircumcised. associated with: uncircumcised, poor hygiene, Herpes/HPV. red, velvety, well-demarcated lesion on glans/prepuce penis. Clinical Importance: high risk of transforming into invasive carcinomaErythroplasia of Queyrat
Begins in glans/inner prepuce. papillary/flat lesions. most common type: squamous cell carcinoma (95%). Tend to be low-grade type. painless lesion
Question Answer
Obstruction and infection inguinal lymph node involvement Carcinoma Penis
Exophytic, locally invasive. well-differentiated variant of squamous cell carcinoma. metastases are rare. good prognosis. Radiation is contraindictedverrucous carcinoma
Abnormal dilatation, and tortousity of veins of Pampiniform plexus draining the testis. incompetent valves in the testicular vein, permitting transmission of hydrostatic venous pressure. presumably because of venous drainage of the left testes into the left renal vein, causing increased retrograde venous pressure. "bag of worms" on palpation. may lead to infertility in some menVaricocele
Twisting of spermatic cord. cuts off venous drainage. arteries remain patent. leading to vascular engorgement. Neonatal occurring in utero or soon after birth. Adolescence. ‘hemorrhagic’ (red) testicular infarction. urologic emergency. sudden pain, without preceding injury. if treated within 6 hours, testis can be salvaged. cremasteric reflex is absentTorsion of testis
(Insert 25-26)
Question Answer
Males afflicted by mumps virus. school children. usually noted as the parotid swelling is a warning sign. Complication: testicular atrophyMumps Orchitis
Sexually transmitted disease due to specific Chlamydia variants. Chlamydia trachomatis (L1, L2, L3). obligate intracellular bacteria. Morphology: mixed granulomatous and neutrophilic inflammatory response. Chlamydial inclusion seen within cytoplasm of epithelial or inflammatory cells. regional lymphadenopathyLymphogranuloma venereum
Incomplete testicular descent. affecting 2%–4% of full-term male newborns and up to 30% of premature infants 3 to 5% full term male births. may be associated with other defects. increased incidence with prematurityCryptorchidism
Most common type. 6 per 100,00 (USA). 300 deaths per yr. (USA). 15 to 34 yrs. Caucasians. Risk Factors - testicular dysgenesis syndrome
Germ cell tumors contains cells resembling primodial germ cellsSeminomatous
Germ cell tumors contains cells undifferentiated cells resembling embryonic stem cellsNon-seminomatous
3rd decade of life (never seen in infants). homogenous, solid, gray-white tumor, appears lobulated on cut section. extension to epididymis, spermatic cord or scrotal sac may be seen. classical/typical seminoma consists of uniform appearing cell. ‘fried egg appearance’. some tumors may produce β-hCG expression. OCT3/4 and NANOGSeminoma
Painless testicular mass. metastases to retroperitoneal lymph nodes. excellent prognosis. no transilluminationSeminoma
Uncommon. older male. slow growing. no metastases. Morphology - soft, pale gray on gross. excellent prognosisSpermatoctic seminoma
Undifferentiated and pluripotent more aggressive presents with metastasis in one-third of cases. Gross - smaller lesion, does not replace the entire testis. poor demarcation, areas of hemorrhage/necrosis. tumor extension to epididymis or cord seenEmbryonal carcinoma
Most common in infants and children up to 3 yrs. Gross - non-encapsulated, homogeneous yellow-white. Micro - lace-like pattern formed by cuboidal to flattened cells. forms Schiller-Duval bodies. eosinophilic bodies that are α-fetoprotein (AFP) positive. Clinical Features - more aggressive. good prognosisYolk sac tumor
Eosinophilic bodies that are α-fetoprotein (AFP) positive. Associated with Yolk Sac TumorSchiller-Duval Body
Rare, young adults, highly malignant. both, cytotrophoblasts & synctiotrophoblasts must be present. however, no villi identified. Gross - tend to be small lesions (palpable). presence of hemorrhage/necrosis. positive for β-Hcg. Clinical Features - increased levels of β-Hcg. structural similarity of β-Hcg to TSH, FSH, and LH may produce hyperthyroidism or gynecomastiaChoriocarcinoma
Derived from more than one germ cell layer. large tumors, solid with cystic areas. collection of differentiated cells. elements may be mature or immature. in postpubertal male, all teratomas are regarded as malignant. Clinical - good prognosis in young, and especially so if it is matureTeratoma
Elaborate androgens. arise in any age group. gynecomastia may be a presenting feature. well circumscribed tumors. appears similar to Leydig cells. contain rod-shaped crystalloids of ReinkeLeydig Cell Tumors
Hormonally silent. presents a testicular mass. histological: benignSertoli Cell Tumor