Diseases of male genital system

Male Genital Tract(short version)

• Penis: Congenital, Inflammation, Tumors

• Testis/Epididymis: Congenital, Regressive, Inflammation, Vascular diseases, Tumors

• Prostate: Inflammation, Benign Enlargement, Malignancy

www.freelivedoctor.com


• Testis/Epididymis: – Congenital– Regressive – Inflammation – Vascular diseases – Tumors



• Testis/Epididymis: – Congenital: Cryptorchidism 1%– Regressive: Atrophy– Inflammation: Mumps, GC, Chlamydia, E. Coli,

Pseudomonas, TB– Vascular diseases: Torsion– Tumors: Benign/Malig, Germ Cell/non-Germ Cell


Cryptorchidism

• 1% of all births• 25% bilateral• Associated with significantly increased incidence of

germ cell tumors



• Testis/Epididymis: – Congenital: Cryptorchidism 1%– Regressive: Atrophy– Inflammation: Mumps, GC, Chlamydia, E. Coli,

Pseudomonas, TB– Vascular diseases: Torsion– Tumors: Benign/Malig, Germ Cell/non-Germ Cell


Testicular Atrophy

• atherosclerotic narrowing of the blood supply in old age

• the end stage of an inflammatory orchitis, whatever the etiologic agent

• cryptorchidism• hypopituitarism• generalized malnutrition or cachexia• irradiation• prolonged administration of female sex hormones, as in treatment of

patients with carcinoma of the prostate; and cirrhosis



• Testis/Epididymis: – Congenital: Cryptorchidism 1%– Regressive: Atrophy– Inflammation: Mumps, GC, Chlamydia, E.

Coli, Pseudomonas, TB– Vascular diseases: Torsion– Tumors: Benign/Malig, Germ Cell/non-

Germ Cell



• Testis/Epididymis:

– Congenital: Cryptorchidism 1%– Regressive: Atrophy– Inflammation: Mumps, TB, GC, Chlamydia,

E. Coli, Pseudomonas– Vascular diseases: Torsion– Tumors: Benign/Malig, Germ Cell/non-

Germ Cell



• Testis/Epididymis: – Congenital: Cryptorchidism 1%– Regressive: Atrophy– Inflammation: Mumps, GC, Chlamydia, E.

Coli, Pseudomonas, TB– Vascular diseases: Torsion– Tumors: Benign/Malig, Germ Cell/non-

Germ Cell


Testicular TUMORS

• GERM CELL (malig.)– SEMINOMA– EMBRYONAL– CHORIOCARCINOMA– YOLK SAC– TERATOMA

– MIXED, 60%

• NON-GERM (benign)• CELL, i.e., “sex cord”

– LEYDIG– SERTOLI


Seminoma

(look for germ cells and lymphs)


Embryonal Carcinoma,

Formerly called “adeno”carcinoma, so look for “glands” and AFP!!!)


CHORIOCARCINOMAlook for “trophoblast”, and HCG!!


YOLK SAC TUMOR, aka “endodermal sinus tumor”

Schiller-Duvall Bodywww.freelivedoctor.com

TERATOMAMALIGNANT TERATOMA

TERATOCARCINOMA

neural tissue

retina

muscle bundles

islands of cartilage

clusters of squamous epithelium

structures reminiscent of thyroid gland

bronchial or bronchiolar epithelium

bits of intestinal wall or brain substance


SEX Cord Tumors

• Leydig, tumor cells look like Leydig cells

• Sertoli , tumor cells look like sertoli cells


STAGING• Stage I: Tumor confined to the testis,

epididymis, or spermatic cord • Stage II: Distant spread confined to

retroperitoneal nodes below the diaphragm • Stage III: Metastases outside the

retroperitoneal nodes or above the diaphragm


PROSTATE• INFLAMMATIONS

• BENIGN ENLARGEMENT

• MALIGNANT TUMORS


CZ = CENTRAL

TZ = TRANSITIONAL

PZ = PERIPHAL


PROSTATE• INFLAMMATIONS

• BENIGN ENLARGEMENT

• MALIGNANT TUMORS


PROSTATITIS• ACUTE, usually same as Urinary Tract

Pathogens

• CHRONIC, usually A-bacterial, but also often recurrent or persistent from acute

• GRANULOMATOUS, non-TB or TB


“BENIGN” Enlargement• BPH• BPH• Glandular and Stromal Hyperplasia• “Nodular” Hyperplasia• Associated with old age• Associated with urinary obstruction, frequency,

bladder hypertrophy and bladder trabeculations• By itself, it is NOT premalignant, however….


P.I.N.www.freelivedoctor.com

NUCLEOLI, NUCLEOLI, NUCLEOLINUCLEOLI, NUCLEOLI, NUCLEOLIwww.freelivedoctor.com

PERINEURAL INVASION www.freelivedoctor.com

BIOLOGIC BEHAVIOR

• NORMAL PROSTATE • HYPERPLASIA

• P.I.N. (Prostatic Intraepithelial Neoplasia), is like “dysplasia leading to adenocarcinoma-in situ

• INFILTRATION of “stroma” • CAPSULE • LYMPH NODES • DISTANT, especially BONE


GRADING• GLEASON SCORE = Predominant

pattern (1-5) + Secondary pattern (1-5)

• Best Score = 2, Worst Score = 10


STAGING


TID-BITS• Prostate is #1 most common malignancy in men but NOT

#1 killer. WHY?• 80% over 80• Every elderly male presenting with widespread bone

metastases is carcinoma of the prostate until proven otherwise

• PSA (Prostate Specific Antigen) has been controversial as a screening test but is GREAT for follow up of a known prostate cancer


Diseases of male genital system

Documents

Transcript of Diseases of male genital system