115 Questions
What is the main distinction between the origins of carcinomas and nodular hyperplasia?
Nodular hyperplasia arises from more centrally situated glands while carcinomas are palpable during digital examination.
What is a common cause of acute bacterial prostatitis?
Staphylococcus aureus
How might organisms reach the prostate in cases of acute prostatitis with concomitant acute urethritis and cystitis?
Through direct extension from the urethra or urinary bladder
What can follow episodes of acute prostatitis or develop insidiously without previous episodes of acute infection?
Chronic bacterial prostatitis
Which nonbacterial agent is implicated in nongonococcal urethritis and can also be associated with chronic prostatitis?
Chlamydia trachomatis
What are the pathological features of acute prostatitis?
Acute neutrophilic inflammatory infiltrate, congestion, and stromal edema
What confirms prostatic inflammation in cases of chronic abacterial prostatitis?
Increased number of leukocytes in prostatic secretions
How might prostatitis complicate infections from distant sites other than the urethra or urinary bladder?
Through blood from distant sites
What treatment options can inhibit the growth of many prostatic carcinomas?
Orchiectomy
Which racial group shows a higher risk of symptomatic carcinoma at an earlier age?
Blacks & Asians
What is suggested by the similar frequency of latent prostatic cancers in all races?
Race influences the growth of established lesions more than initial development
Where have susceptibility loci on chromosome 1 been identified in familial cases of prostate cancer?
Chromosome 1
Is the incidence of carcinoma of the prostate higher in Scandinavian countries or in Japan and certain other Asian countries?
Scandinavian countries
What environmental factor is suggested by the increased frequency of prostatic carcinoma in certain industrial settings?
Diet high in animal fat
'Males immigrating from low-risk to high-risk areas maintain a lower risk of prostate cancer' - What does this suggest about the risk of disease in subsequent generations?
'Risk increases'
'A diet high in animal fat has been a factor' - A factor for what?
'Development of prostatic carcinoma'
What is required for a histologic diagnosis of chronic prostatitis?
Presence of tissue destruction, fibroblastic proliferation, lymphocytes, and neutrophils
In which condition can granulomatous prostatitis be seen?
Disseminated TB
What is a characteristic feature seen microscopically in granulomatous prostatitis?
All of the above
Which clinical manifestation is NOT typically associated with prostatitis?
Hemoptysis
What is a common symptom of acute prostatitis?
Fever and leukocytosis
What kind of reaction is granulomatous prostatitis to a variety of insults?
Morphologic reaction
When is caseous necrosis typically seen in prostatic tissue?
In tuberculous prostatitis
Which of the following is a manifestation of chronic prostatitis?
Poorly localized suprapubic pain
What are the etiological factors associated with squamous cell carcinomas of the penis?
Exposure to potential carcinogens in smegma, smoking, and HPV infection
What is a common precursor to squamous cell carcinomas of the penis?
Intraepithelial neoplasia
What age group is more commonly affected by squamous cell carcinomas of the penis?
Adults over 40 years old
How are squamous cell carcinomas of the penis characterized in relation to circumcision?
They are more common in uncircumcised individuals
Which type of human papillomavirus (HPV) infection is particularly associated with squamous cell carcinomas of the penis?
HPV type 16 and 18
What is a potential consequence of poor hygiene in relation to squamous cell carcinomas of the penis?
Higher likelihood of exposure to potential smegma carcinogens
How do early lesions of prostate cancer typically appear?
Firm, gray-white to yellow lesions just beneath the capsule
What is the most common location for the majority of prostate cancers to arise?
Peripheral glands
Which structure usually prevents the growth of the tumor posteriorly in cases of prostatic adenocarcinoma?
Denonvilliers fascia
What is a common feature of the foci of carcinoma seen on the cut surface of the prostate?
Gray-white to yellow lesions with ill-defined margins
What happens when locally advanced prostate cancers infiltrate the seminal vesicles?
May invade adjacent soft tissues and urinary bladder
Which structure separates the lower genitourinary structures from the rectum in cases of prostatic adenocarcinoma?
Denonvilliers fascia
When do metastases to regional pelvic lymph nodes typically occur in cases of prostate cancer?
In early stages of the disease
How does prostate cancer typically present on rectal digital examination?
'Irregular hard' nodules
What is a common etiological factor for squamous cell carcinomas of the penis?
Smoking
Which age group is most commonly affected by squamous cell carcinomas of the penis?
Over 40 years old
What is a notable risk factor for developing testicular neoplasms?
Cryptorchidism
Which human papillomavirus (HPV) types are particularly associated with squamous cell carcinomas of the penis?
Types 16 and 18
What can precede squamous cell carcinomas of the penis and may eventually lead to carcinoma in situ?
Dysplastic changes
What is a potential complication associated with cryptorchidism?
Testicular neoplasms
Which of the following is a characteristic feature of squamous cell carcinomas of the penis?
"Carcinoma in situ"
"Prostatic neoplasms are relatively uncommon in which group of individuals?"
"Circumcised individuals"
What is a common feature of early lesions of prostate cancer beneath the capsule of the prostate?
Smooth and well-defined masses
Why is urethral obstruction less likely in the initial stages of prostate cancer compared to nodular hyperplasia?
Prostate cancer arises in the outer glands
In cases of prostatic adenocarcinoma, what may prevent the growth of the tumor posteriorly?
Seminal vesicles
What is a characteristic feature of foci of carcinoma on the cut surface of the prostate?
Sharp and well-defined margins
What structure separates the lower genitourinary structures from the rectum in cases of prostatic adenocarcinoma?
Prostate capsule
Where do metastases to regional pelvic lymph nodes typically occur early in cases of prostate cancer?
Seminal vesicles
How do majority of prostate cancers typically arise in relation to their location within the glands?
In inner central glands
What is the major hormonal stimulus for stromal and glandular proliferation in men with nodular hyperplasia?
Dihydrotestosterone
Which zone of the prostate is most commonly affected by hyperplastic lesions?
Transitional
What is the characteristic feature of BPH?
Proliferation of both stromal and epithelial elements
Which age group is significantly affected by BPH?
Men by the age of 40 and older
What role do androgens play in the pathogenesis of BPH?
Central role
Where do most carcinomas arise in the prostate?
Peripheral zones
What does DHT bind to in men with nodular hyperplasia?
Nuclear androgen receptors
What is a reliable indicator of the presence of a nonseminomatous component to the germ cell neoplasm?
Elevated AFP levels
Which germ cell tumor may also secrete hCG, although at a lower rate compared to choriocarcinoma?
Seminoma
What is the function of hCG in patients with choriocarcinoma?
Contribute to tumor growth
Which tumor marker indicates the presence of neoplastic syncytiotrophoblastic cells in germ cell tumors?
hCG
In germ cell tumors, what does elevation of both hCG and AFP levels suggest?
Nonseminomatous tumor with yolk sac elements
What is the primary role of serial determinations of hCG and AFP in germ cell tumors post-therapy?
Monitoring for tumor recurrence
What is the significance of elevated AFP levels in germ cell tumors?
Reliable indicator for nonseminomatous component
Which tumor marker differentiates between pure seminomas and those with nonseminomatous components?
AFP
What grading system for carcinoma of the prostate is commonly used and correlates well with the stage and prognosis of the disease?
Gleason system
How may more extensive prostate cancer disease typically manifest?
Local discomfort and lower urinary tract obstruction
What histologic feature allows the neoplastic glands of prostatic adenocarcinoma to be recognizable at high magnification?
Hyperchromatic nuclei
In what percentage of cases are carcinomas localized and discovered unexpectedly during histologic examination of tissues removed for nodular hyperplasia?
~10%
How do the neoplastic glands in prostatic adenocarcinoma differ from normal glands at high magnification?
Hyperchromatic nuclei
What clinical manifestation may reveal aggressive carcinomas that are first noticed due to the presence of metastases?
Hard, fixed prostate
What feature of prostatic carcinoma back to back glands distinguishes them under high magnification?
Intervening stroma present
Which tumor marker is a reliable indicator of the presence of a nonseminomatous component in germ cell neoplasms?
AFP
What is the characteristic tumor marker secreted by neoplastic syncytiotrophoblastic cells in choriocarcinoma?
hCG
Which zone of the normal prostate contains several distinct regions, including central, peripheral, transitional, and periurethral zones?
Central zone
Which tumor marker is commonly associated with germ cell tumors containing yolk sac (endodermal sinus) elements?
AFP
What is the significant hormonal stimulus for stromal and glandular proliferation in men with nodular hyperplasia?
Androgens
What is the major grading system used for prostatic carcinoma that correlates well with the stage and prognosis of the disease?
Gleason system
How do the neoplastic glands of prostatic adenocarcinoma appear at high magnification?
Without intervening stroma and hyperchromatic nuclei
What is a distinguishing feature of prostatic adenocarcinoma lymph node metastasis?
Left supraclavicular lymphadenopathy
In what group of individuals are prostatic neoplasms relatively uncommon?
Females transitioning to males
What tumor marker is typically elevated in choriocarcinoma and differentiates between pure seminomas and nonseminomatous components?
Beta-human chorionic gonadotropin (hCG)
What is a distinctive histopathological feature of seminomas?
Distinct cell borders, clear cytoplasm, and round nuclei with nucleoli
Which age group does embryonal carcinoma most frequently occur in?
25-35 years
What distinguishes prostatic adenocarcinoma from normal glands microscopically?
Back to back forming of glands
What is a common feature of early lesions of prostate cancer beneath the capsule?
Retroperitoneal lymph node metastases
Which marker helps differentiate pure seminomas from those with nonseminomatous components?
Human chorionic gonadotropin (hCG)
What is a common feature of prostatic adenocarcinoma when compared to normal or hyperplastic prostate glands?
Glands are lined by a single layer of cuboidal cells with basal cell layer present
Which tumor marker is commonly elevated in patients with choriocarcinoma?
AFP (Alpha-Fetoprotein)
What histological pattern is suggestive of high-grade prostatic intraepithelial neoplasia (PIN), a possible precursor to prostatic carcinoma?
Papillary structures and cribriform epithelial arrangements
What distinguishes pure seminomas from those with nonseminomatous components in germ cell tumors?
Elevation of both hCG and AFP levels
Which microscopic feature is characteristic of better-differentiated lesions of prostatic adenocarcinoma?
Single layer of cuboidal cells with conspicuous nucleoli
Which testicular germ cell tumor is most commonly encountered in combination with teratoma and yolk sac tumors?
Embryonal carcinoma
In testicular germ cell tumors, which type tends to metastasize earlier via lymphatic and hematogenous routes?
Teratoma
Which location is most common for hematogenous metastases in seminomas?
Liver and lungs
What is the distinctive clinical presentation of individuals with nonseminomatous testicular germ cell neoplasms?
Widespread metastases at diagnosis
Which zone of the prostate is most commonly affected by adenocarcinoma?
Peripheral zone
What is the distinctive feature characterized by the presence of structures resembling primitive glomeruli in a histological section of the testis?
Schiller-Duvall bodies
What is a typical gross characteristic of choriocarcinomas?
Small nonpalpable lesions
Which immunohistochemical staining technique can identify the hormone hCG in choriocarcinomas?
hCG staining
What type of differentiation is represented by sheets of small cuboidal cells intermingled with large eosinophilic syncytial cells in choriocarcinomas?
Syncytiotrophoblastic differentiation
In which cells can AFP be demonstrated within the cytoplasm by immunohistochemical techniques in germ cell tumors?
Neoplastic cells
Which condition is more likely to produce urinary obstruction early in its course than carcinoma?
Nodular hyperplasia
What is the characteristic pathological feature of acute prostatitis?
Neutrophilic inflammatory infiltrate
Which type of prostatitis accounts for most cases of chronic prostatitis?
Chronic abacterial prostatitis
In chronic prostatitis, what confirms prostatic inflammation when bacteriologic findings are negative?
Increased leukocytes in prostatic secretions
What is a significant finding that suggests the presence of a nonseminomatous component in germ cell tumors?
Elevated hCG levels
What pathological feature distinguishes back-to-back glands in prostatic carcinoma under high magnification?
Stromal and glandular proliferation
'A diet high in animal fat has been a factor' - A factor for what condition?
Prostatic adenocarcinoma
'Males immigrating from low-risk to high-risk areas maintain a lower risk of prostate cancer' - What does this suggest about the risk of disease in subsequent generations?
Increased risk of prostatic adenocarcinoma
What is the major hormonal stimulus for stromal and glandular proliferation in men with nodular hyperplasia?
Androgens
What characteristic feature is seen microscopically in granulomatous prostatitis?
Granulomatous inflammation
Test your knowledge on the pathology of prostate infections, including the progression of infection, tissue destruction, and the formation of microabscesses. Learn about the histological features of chronic prostatitis and the inflammatory cells involved.
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