Download Male Genital System

Male Genital System

Testis & epididymidis

Ductus deferrens

Prostata & vesiculae seminales

Penis
Testis
Necrosis
 Atrophy
 Inflammation
 Tumours

Atrophia testium
 Cryptorchidism
 Klinefelter´s
sy
 estrogen administration
 hypopituitarism
 aging
 malnutrition
 cachexia
 radiation chemotherapy
 alcoholic cirrhosis
Granulomatous orchitis
 infectious
– syphlis
– tuberculosis
– leprosy
– fungi
– brucellosis
– parasites
– rickettsiae….
mimicking a neoplasm
 idiopathic
– trauma
– ischemia
– postobstructive changes
– G- urinary tract
infection...
PSEUDOTUMOUR
Germ cell tumours
– seminoma
– embryonal carcinoma
– teratoma (mature, immature)
– yolc sac tumour
– choriocarcinoma
RISK FACTOR: CRYPTORCHIDISM
5x increased
Seminoma

„classic“
(50%)

– frequent as both pure &
combined
– peak incidence 40 years
– swelling
– monomorphous
germinal cell population
– may present with
metastases
– c-kit + (membranously)
spermatocytic
–
–
–
–
rare (1% of all seminomas)
peak incidence 50 years
swelling
polymorphous cell
population
– does not metastasize!
– dif. dg. anaplastic
seminoma
Embryonal carcinoma
 composed
of primitive anaplastic-appearing
epithelial cells
 pure rare, mostly in combined germ cell
tumours
 peak incidence 30 years
 swelling, 2/3 patients with metastases at
diagnosis
 macro : tan/gray, necroses, hemorrhages
 micro: solid, tubular, PLAP, CK +
Mesoblastoma vitellinum- yolc sac
tumour –endodermal sinus tumour
 80%
of prepubertal germ cell tumours
 in postpubertal as admixture
 painless mass, serum AFP elevated
 macro: gray/tan nonencapsulated
 micro: many variants – microcystic,
solid,festoon-like, hepatoid, spindle cell…
 AFP+, alpha1-Antitrypsin
Choriocarcinoma
– 0,5% of testicular tumours
 admixture in many germ cell tumours
 highly malignant
 postpubertal , 2nd-3rd decade
 presents often with metastases
 beta-HCG
 pure
Teratomas
Def.:
Tumours (benign or malignant)
composed of two or more
different cell lines that are NOT
normally present in the place of
tumour origin
Teratoma

coetaneous –
differentiated -cystic

embryonal –
nondifferentiated solid
Prostate
Necrosis
, atrophy
Inflammation
HYPERPLASIA
CARCINOMA
(Benign) Prostatic Hyperplasia



starting over 40, 90% men over 70
years of age
dyshormonal, often symptomless
dysuria - retention:
– infection, infarction, stones
– hydropyelonephritis, urosepsis
Carcinoma prostatae
 frequent
by chance finding at autopsy
 most men die with, not from the prostate
cancer
 etiology unknown
 Serum PSA, sonography discovering
clinically silent forms
 hormonal dependency
 precanceroses PIN (LG, HG)
Diagnosis of the Prostate Cancer
 PSA,
thick needle biopsy
 histology
 immunohistochemistry
– 34β E12, PSA
 grading
(2-10)
 staging
: Gleason grade (1-5) & score
Penis
 congenital
anomalies
– hypospadia, epispadia (changed positions
of the urethra openings)
– phimosis
paraphimosis
 acquired
– infections
– neoplasms