ANSWERS FOR QUESTIONS FOR MALE REPRODUCTIVE SYSTEMS LABORATORY
Case 1: slide 95
1. Nodule or nodules of benign glands, with compressed glands and/or stroma at the periphery of nodules. Some stromal proliferation. 2nd changes of glandular inflammation etc.
2. Yes. BPH originates in the periurethral glands of the prostate and therefore compresses the urethra earlier than prostatic carcinoma which originates in the peripheral zone of the prostate
3. Yes. Obstruction of the urethra predisposes to cystitis
4. Thick bladder wall with trabeculae from smooth muscle hypertrophy in response to obstruction. Possibly diverticula of the bladder
5. There is an increase of BPH with increasing age. From 20% at age 40 to 90% at age 70 (blacks affected earlier than whites)
6. No
Case 2: S90-1412E
1. a, b, and c
2. Embryonal carcinoma
3. No. Mixed germ cell tumors comprise 60% of testicular tumors.
4. Metastases (hematogenous) (May be identical to the original tumor or contain other germ cell elements)
5. Stage III, metastases outside the retroperitoneal nodes or above the diaphragm
6. No
7. No they are relatively radioresistant. Usually a combination of surgery, radiotherapy and chemotherapy is used.
8. Elevated AFP and HCG which remained elevated after the surgical removal of the testis.
Case 3: S87-1645B
1. Yes
2. Coagulation necrosis
3. Hemorrhagic infarct
4. Torsion of the testicle with venous (and possibly arterial obstruction)
5. Pre-existing structural lesions such as incompletely descended testicles, absence of scrotal ligaments or testicular atrophy
Case 4: S92-835 C19
1. a, b and c
2. Prostatic adenocarcinoma (most common form of cancer in men)
3. Peripheral zone of prostate (posterior region)
4. a. Stage D--disseminated disease because of the bone pain and lesions on x-ray.
b. Stage C--locally advanced disease. Since the tumor arises from the peripheral zone, symptoms of urinary obstruction usually only occur with locally advanced disease
5. Yes for both. Prostatic acid phosphatase is usually elevated when there is extracapsular extension, whether locally into the seminal vesicles or bladder or with distant metastases to lymph nodes or bone.
6. Prostate adenocarcinoma produces osteoblastic bone metastases on x-ray (stimulates new bone formation) and lung metastases are more often lytic (erode away existing bone). An immunoperoxidase stain using an antibody to prostate specific antigen should stain positively in most prostatic adenocarcinomas and negatively in carcinomas of other origins.
7. For advanced disease--stage C and D-- hormonal manipulation: orchiectomy, estrogen administration and luteinizing hormone releasing hormone
8. Yes, markedly increased incidence in 70 + age group
9. Direct extension to seminal vesicles or bladder, lymphatic metastases to pelvic lymph nodes, and hematogenous spread primarily to bone
Case 5: S79-5628 (W or CC)
1A. e
1B. a. embryonal (while yolk sac tumor, a teratoma with malignant transformation or a mixed tumor could have similar areas, they would have other features specific for their diagnosis).
b. teratoma
c. spermatocytic seminoma
d. choriocarcinoma
2. Seminoma
3 A. No
B. Stage I (70% of seminomas are localized to testis, stage I)
4. A. Lymph node metastases (Seminomas tend to metastasize via lymphatics)
B. Stage II (lymph nodes positive in the abdomen--below the diaphragm)
5. Yes. Seminomas are relatively radiosensitive
6. No. In contrast to other germ cell tumors, only 7% of seminomas have elevated HCG