Male Genital System Pathology – Review Flashcards

Question-and-answer flashcards covering congenital penile anomalies, infections, testicular disorders and tumors, and prostate pathology, designed to reinforce key concepts for exam preparation.

What congenital anomaly features the urethral opening on the inferior (ventral) surface of the penis?

Hypospadias, due to failure of the urethral folds to close.

Which developmental failure leads to hypospadias?

Incomplete fusion of the urethral folds.

Which condition presents with the urethral opening on the superior (dorsal) surface of the penis?

Epispadias.

What embryologic error causes epispadias?

Abnormal positioning of the genital tubercle.

Epispadias is classically associated with which bladder abnormality?

Bladder exstrophy.

Which benign warty growth on genital skin is caused by HPV 6 or 11?

Condyloma acuminatum.

What microscopic change characterizes condyloma acuminatum?

Koilocytic change (perinuclear cytoplasmic clearing).

Necrotizing granulomatous inflammation of inguinal lymphatics caused by Chlamydia trachomatis serotypes L1-L3 is called what?

Lymphogranuloma venereum.

Perianal involvement in lymphogranuloma venereum can heal with fibrosis and lead to what complication?

Rectal stricture.

Name two major risk factors for penile squamous cell carcinoma.

High-risk HPV infection and lack of circumcision (chronic foreskin irritation).

Which high-risk virus types are found in roughly two-thirds of penile SCC cases?

Oncogenic HPV types (e.g., 16, 18).

What in-situ lesion presents as leukoplakia on the penile shaft or scrotum?

Bowen disease.

Which in-situ carcinoma appears as an erythematous patch on the glans penis?

Erythroplasia of Queyrat.

Multiple reddish papules on the penis in a 40-year-old man that rarely progress to cancer describe which lesion?

Bowenoid papulosis.

Failure of a testis to descend into the scrotal sac is called what?

Cryptorchidism.

List two long-term complications of untreated cryptorchidism.

Testicular atrophy/infertility and increased risk of seminoma.

By what age is orchiopexy recommended if cryptorchidism does not resolve spontaneously?

Before 2 years of age.

In young men with orchitis, which two sexually transmitted bacteria are common causes?

Chlamydia trachomatis (D-K) and Neisseria gonorrhoeae.

E. coli or Pseudomonas orchitis is typically seen in which patient group?

Older adult males with urinary tract infections.

Mumps orchitis after puberty increases the risk of what reproductive consequence?

Infertility.

Autoimmune orchitis is characterized by granulomas involving which testicular structure?

Seminiferous tubules.

What vascular event underlies testicular torsion?

Twisting of the spermatic cord obstructing thin-walled veins → congestion & hemorrhagic infarction.

Sudden testicular pain with absent cremasteric reflex in an adolescent suggests what diagnosis?

Testicular torsion.

A scrotum that feels like a “bag of worms” indicates what condition?

Varicocele (dilated pampiniform veins).

Varicocele is usually left-sided and is associated with which kidney tumor?

Left-sided renal cell carcinoma (invasion of left renal vein).

What is a hydrocele?

Fluid collection within the tunica vaginalis around the testis.

State one infantile and one adult cause of hydrocele.

Infant: Patent processus vaginalis communicating with peritoneum; Adult: Blocked lymphatic drainage.

How can a hydrocele be distinguished on physical exam?

Scrotal swelling transilluminates with light.

What is the most common type of testicular tumor?

Malignant germ cell tumor (>95%).

Name two risk factors for developing germ cell tumors.

Cryptorchidism and Klinefelter syndrome.

Which testicular tumor is composed of large clear cells with central nuclei, forms a homogeneous mass without hemorrhage, and has an excellent prognosis?

Seminoma.

Which serum marker may be mildly elevated in some seminomas?

β-hCG.

A hemorrhagic, necrotic testicular mass comprised of primitive cells that may form glands describes which tumor?

Embryonal carcinoma.

What serum markers can be elevated in embryonal carcinoma?

AFP and/or β-hCG.

Which is the most common testicular tumor of childhood and is associated with Schiller-Duval bodies and ↑AFP?

Yolk sac (endodermal sinus) tumor.

A highly malignant testicular tumor of syncytiotrophoblasts & cytotrophoblasts with early hematogenous spread is called what?

Choriocarcinoma.

Markedly elevated β-hCG in choriocarcinoma can produce which two clinical effects?

Gynecomastia and hyperthyroidism (βhCG α-subunit mimics LH/FSH/TSH).

Why is testicular teratoma considered malignant in males but not usually in females?

Teratomas behave aggressively and can metastasize in males regardless of mature tissue composition.

In a mixed germ cell tumor, prognosis is based on what?

The most aggressive (worst) histologic component present.

Which testicular stromal tumor secretes androgens, causes precocious puberty or gynecomastia, and shows Reinke crystals?

Leydig cell tumor.

A usually silent testicular tumor made of tubules, derived from sex cord stroma, is called what?

Sertoli cell tumor.

What is the most common testicular mass in men over 60, often bilateral and of diffuse large B-cell type?

Testicular lymphoma.

Which bacteria commonly cause acute prostatitis in young vs. older men?

Young: Chlamydia trachomatis, N. gonorrhoeae; Older: E. coli, Pseudomonas.

In chronic prostatitis, prostatic secretions contain WBCs but cultures show what result?

Negative bacterial cultures.

Which androgen metabolite drives benign prostatic hyperplasia (BPH)?

Dihydrotestosterone (DHT).

BPH classically arises in which zone of the prostate?

Central periurethral (transitional) zone.

List three classic urinary symptoms of BPH.

Hesitancy/weak stream, dribbling, incomplete bladder emptying with frequency or nocturia.

How does an α1-antagonist (e.g., terazosin) help in BPH?

Relaxes prostatic & vascular smooth muscle, improving urine flow (and lowering BP).

What is the chief advantage of selective α1A-antagonists such as tamsulosin?

Relieve urinary symptoms without significant blood-pressure lowering in normotensive men.

Name two benefits and two side effects of 5-α-reductase inhibitors in BPH.

Benefits: Shrink prostate, treat male pattern baldness; Side effects: Gynecomastia, sexual dysfunction (↓libido/ED).

Describe PSA changes that raise suspicion for prostate cancer versus BPH.

Cancer: PSA >10 ng/mL or ↓% free-PSA; BPH: Mild PSA rise, usually <10 ng/mL, with relatively higher % free-PSA.

List three major risk factors for prostate adenocarcinoma.

Advanced age, African-American race, diet high in saturated fats.

Where in the prostate does carcinoma most commonly arise, and why is this clinically silent early?

Peripheral posterior zone—far from urethra, so urinary symptoms appear late.

What grading system is used for prostate cancer and what does a higher score imply?

Gleason grading (2-10); higher score = worse prognosis.

Prostatic carcinoma frequently spreads to which bones, and what radiologic pattern is seen?

Lumbar spine/pelvis with osteoblastic (sclerotic) lesions.

Which two drug classes are used to reduce androgenic stimulation in advanced prostate cancer?

Continuous GnRH analogs (e.g., leuprolide) and androgen-receptor antagonists (e.g., flutamide).