1. Origin for benign prostatic hyperplasia
(BPH)…so it mainly causes urinary obstruction
The most common site of origin for prostate cancer…so perrectal (PR)
exam is important

3. Nodules in BPH

4. Normal Basal cell layer, present in benign and absent in malignant
Columnar epithelial layer
Corpora amylacea
Fibromuscular stroma…fibroblasts & smooth muscle cells

5. BPH A nodule formed of glands The glands are large and branching
Some nodules are just: stromal nodules

6. Large branching glands
BPH…high power
The cells are more in number with stratification
Large branching glands
Corpora amylacea

7. Multiple sections from a radical prostatectomy
…multiple yellowish lesions here represent carcinoma…note that the gland is not much enlarged

8. Prostatic adenocarcinoma
…small glands
…crowded glands
…decreased secretions
…absent basal layer

9. Prostatic carcinoma high grade (Gleason 5)
…poorly differentiated composed of infiltrating
cells that are not forming glands
…note the prominent nucleoli and the pleomorphic
enlarged nuclei

10. Normal testis
Atrophic testis…
multiple causes . e.g., cryptorchidism, infection (e.g., mumps)…etc.

11. Spermatid (sesame-like)…so maturation is good
Normal adult testis
Spermatid (sesame-like)…so maturation is good
A seminiferous tubule
Sertoli cells at the periphery
Different stages of spermatogenesis

12. Prepubertal testis
…just sertoli cells

13. Atrophic fibrotic tubules due to radiotherapy, infection…etc.
Focal atrophy
Atrophic fibrotic tubules due to radiotherapy, infection…etc.
Normal seminiferous tubules

14. Atrophic testis
Note the thickening of tubular BM…this accompanies atrophy
Only sertoli cells…no spermatogenesis

15. Hydrocele
…fluid around the testis…it transilluminates because it contains serous fluid
But a tumor or hematocele will not transilluminate

16. Testicular gangrene (red infarction) because the mechanism is venous congestion due to torsion of testis which is an emergency to prevent gangrene

17. A tumor in testis…it is well circumscribed and without hemorrhage or necrosis (features that prefer seminoma)

18. Rim of the remaining testis
A large lobulated seminoma

19. Seminoma
Dense lymphocytic infiltrate
Normal testis remnant
Islands of malignant cells which have large nuclei and clear to pale cytoplasm

20. Seminoma
Note the atypia and prominent nucleoli

21. Seminoma

22. Embryonal carcinoma
Epithelium-like structures that are formed of large cells with prominent pleomorphism and atypia

23. Part of cyst wall (part of cystic teratoma)
Cartilagenous area (part of teratoma)
Mixed germ cell tumor (this example is: teratoma + embryonal carcinoma = teratocarcinoma…the most common combination)
Friable, necrotic and hemorrhagic part (features commonly seen in embryonal carcinoma)
No normal testicular remnant is seen

24. Mixed germ cell tumor (this example is: teratoma + embryonal carcinoma = teratocarcinoma…the most common combination)
Embryonal carcinoma focus
Cartilage…part of teratoma

25. Bowen disease of penis
= squamous cell carcinoma in situ
…it cannot be differentiated microscopically from Bowenoid papulosis
The full thickness of epidermis shows markedly enlarged nuclei with pleomorphism, hyperchromasia & prominent nucleoli…+ loss of maturation
…BM is intact

26. Bowen disease of penis
The full thickness of epidermis shows markedly enlarged nuclei with pleomorphism & prominent nucleoli…+ loss of maturation
…BM is intact
All this is a nucleus…note that this nucleus is very atypical but not necessarily to be hyperchromatic (it has open (white) chromatin pattern)

27. Thank You