Pathology of the Urogenital Tract Male Genital Tract March 24, 2014.

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Presentation transcript:

Pathology of the Urogenital Tract Male Genital Tract March 24, 2014

Case 1

Q1 Name the organ. Describe the normal histology.

Q2. Name the organ. Describe the normal histology

Q3 Describe the normal histology (high power)

Case 2

HISTORY: A 32-year-old previously healthy man presents with a painless mass in his left testicle. He noticed it about 1 month ago. It was not getting smaller so he sought medical attention. VITAL SIGNS: 135/80 HR 80 RR 15 T 98° PHYSICAL EXAMINATION: Palpable, mobile 3 cm non-tender mass is present in the left testicle. Exam is otherwise unremarkable. There is no inguinal lymphadenopathy.

Q1: What is the main clinical problem and differential diagnosis?

LAB TESTS Chest X-ray is normal Serum AFP and HCG are normal

Q2: Describe gross findings

Q3: Describe the pathologic changes

Q4:What is your diagnosis?

Q5: List the key clinical and pathologic features of this tumor.

Case 3

HISTORY: 67-year-old male has nocturia, urinary hesitancy (difficulty in starting and stopping urine flow), “weak” urine stream, and dribbling at the end of urination. PHYSICAL EXAMINATION: On digital rectal exam the prostate gland is enlarged and non-tender. There are no palpable masses.

Q1: What is the clinical problem and list your differential diagnosis?

LAB TESTS: Prostate specific antigen (PSA) is within normal limits for a man this age.

Q2:Describe gross findings

Q3: Identify organ and describe the pathologic changes

Q4: What is your diagnosis?

Q5: What complications may occur because of this problem?

Q6: What hormone is related to this process?

Case 4

HISTORY: A 72-year-old man presents with back pain. It is constant and exacerbated by movement. The pain often keeps him up at night. PHYSICAL EXAMINATION: There is tenderness over the lower spine. Neurologic exam is normal. A single, hard prostatic nodule is palpated on digital rectal exam. No lymphadenopathy is noted.

Q1: What are the main clinical problems and differential diagnosis ?

RADIOGRAPHY: Osteoblastic vertebral lesions are noted on x-rays of the spine. LAB TESTS: PSA H ( NG/ML)

Transrectal Biopsy of Prostate

Q2: Describe the gross findings

Q3:Identify organ and describe the pathologic changes

Q4. What is your diagnosis?

Q5: What is a Gleason grade?

Q6: What is a Gleason score?

Q7: Which genetic changes may occur in this process?

Q8: Correlate the clinical and radiographic findings with the pathologic diagnosis:

Case 5

HISTORY: 62-year-old man presents with hematuria. He has no difficulty in voiding and no flank or back pain. He has a history of smoking. PHYSICAL EXAMINATION: Unremarkable. LAB TESTS: Urinalysis 4+ blood 1+protein red blood cells/high power field

Q1: What is the main clinical problem?

Q2: What is the clinical differential diagnosis?

Cystoscopic Findings Urine Cytology Q3: Describe the following findings:

Q4: Identify organ and describe the pathologic changes

Q5: What is your diagnosis?

Q6: What are the epidemiologic predisposing factors to this process?