Male Reproductive System Pathology

PSA, or prostate-specific antigen, is the most important marker for prostate cancer. PSA is a protein produced by both normal and cancerous prostate cells. Elevated levels of PSA in the blood can indicate the presence of prostate cancer. Therefore, monitoring PSA levels is crucial in diagnosing and monitoring the progression of prostate cancer. The other options, BRCA1 and None of the above, are not relevant markers for prostate cancer. "All of the above" and "Who cares" are not valid options.

The most common cause of acute prostatitis is E. coli. E. coli is a type of bacteria that commonly resides in the gastrointestinal tract. It can enter the prostate gland through the urethra, leading to infection and inflammation. This can result in symptoms such as dysuria, increased frequency and urgency, low back and pelvic pain, fever chills, and sexual dysfunction. Other bacteria such as Strep and Staph can also cause prostatitis, but E. coli is the most common culprit. Fungi are not a common cause of acute prostatitis.

The correct answer is "No, it is also found in hyperplasia and prostitis." This is because prostate-specific antigen (PSA) is a protein produced by both cancerous and noncancerous cells in the prostate gland. Elevated levels of PSA can indicate the presence of prostate cancer, but it can also be caused by benign conditions such as benign prostatic hyperplasia (enlarged prostate) and prostatitis (inflammation of the prostate). Therefore, serum PSA is not specific to cancer and can be found in other noncancerous conditions as well.

The function of 5-alpha reductase is to convert testosterone into dihydrotestosterone. This conversion is important for the development of male sexual characteristics during puberty. Dihydrotestosterone is a more potent form of testosterone and plays a crucial role in the development of the male external genitalia, prostate, and other androgen-dependent structures. In individuals with 5-alpha reductase deficiency, this conversion is impaired, leading to incomplete or abnormal development of male sexual characteristics.

AFP (alpha-fetoprotein) levels are increased in a 2-year-old child presenting with a well-demarcated tumor with cuboidal columnar cells in sheets and papillae, called Schiller duval bodies. AFP is a tumor marker commonly associated with certain types of cancer, including hepatocellular carcinoma and germ cell tumors. In this case, the presence of Schiller duval bodies suggests a germ cell tumor, which is a type of cancer that can cause an increase in AFP levels.

The most appropriate treatment for a man with benign prostatic hyperplasia would be targeting 5a-reductase activity. Benign prostatic hyperplasia is characterized by an enlargement of the prostate gland, which is dependent on the conversion of testosterone to dihydrotestosterone (DHT) by the enzyme 5a-reductase. Inhibiting 5a-reductase activity would reduce the production of DHT, which would help in reducing the size of the prostate gland and alleviate symptoms associated with benign prostatic hyperplasia.

The patient's symptoms of increased urgency to void, inability to completely empty the bladder, and feeling distended and irritated all point towards a diagnosis of benign prostate hyperplasia (BPH). The enlarged, rubbery prostate on rectal digital exam further supports this diagnosis. The biopsy findings of prostatic glands lined by slightly pleomorphic columnar epithelium surrounded by an intact layer of basal cells are consistent with BPH, as this condition is characterized by an increase in the number of glandular and stromal cells in the prostate. This is in contrast to prostate adenocarcinoma, which would typically show more significant pleomorphism and loss of basal cells.

The fetus in this case has only one testes because the other one has not completely descended, which is a characteristic of Pader Willi syndrome. Microscopically, there is leydig cell hyperplasia and hyalinised tubules. This combination of findings suggests an increased risk of seminoma of the testes. Therefore, the correct answer is seminoma of the testes.

In this patient with an enlarged prostate gland, the increased proliferation of stromal and epithelial cells suggests benign prostatic hyperplasia (BPH). BPH is a common condition in older men where the prostate gland enlarges, causing urinary symptoms such as difficulty starting or stopping urination, dribbling, nocturia, and bladder fullness. Testosterone, a male hormone, plays a role in the growth and development of the prostate gland. However, in BPH, the conversion of testosterone to dihydrotestosterone (DHT) within the prostate gland is increased, leading to prostate cell proliferation. Therefore, the levels of testosterone are decreased in this patient.

Finasteride is a drug that can decrease the synthesis of dihydrotestosterone from testosterone. It works by inhibiting the enzyme 5-alpha reductase, which is responsible for converting testosterone into dihydrotestosterone. By blocking this enzyme, finasteride reduces the levels of dihydrotestosterone in the body. This can be beneficial in the treatment of conditions such as benign prostatic hyperplasia and male pattern baldness, which are associated with high levels of dihydrotestosterone.

Structure and function of the prostate depend on the level of testosterone.
READ. Zones- ducts from individual glands may converge but all empty direclty into the prostatic urethra (running through the center of the prostate). Central zone- 25% of glands volume and has submucosal galnds with longer ducts. Peripheral zone- occupies 70% of prostate gland with still longer ducts. Glands in this zone are the most common locatino of both inflammation and cancer.
(Slide 39-Thompson -Male Repro)

The most likely diagnosis in this case is chronic abacterial prostatitis. The patient's symptoms of perineal pain and increased frequency of urination, along with the mildly enlarged and tender prostate, are consistent with chronic prostatitis. The presence of leukocytes in the prostatic secretions indicates inflammation, but the absence of bacteria in cultures suggests that the inflammation is not caused by an infection. Chronic abacterial prostatitis is the most common type of prostatitis and is characterized by persistent inflammation of the prostate without evidence of infection.

The presence of gynecomastia, a non-tender testicular mass, and the histological findings of a well-circumscribed brown mass composed of large polygonal cells with homogenous eosinophilic cytoplasm, along with the presence of elongated cytoplasmic crystals in some neoplastic cells, are consistent with a Leydig cell tumor. Leydig cell tumors are rare testicular tumors that can produce estrogen, leading to gynecomastia. The histological features described are characteristic of Leydig cell tumors. Varicocele, cryptorchidism, yolk sac tumor, embryonal carcinoma, and Sertoli cell tumor are not associated with these findings.

If a male infant does not have testes in his scrotum, it suggests that they may be undescended or absent. In such cases, there is a higher risk of developing a malignant tumor called testicular cancer. Testicular cancer commonly spreads through the lymphatic system. The retroperitoneal para-aortic lymph nodes, located in the abdomen, are the primary drainage pathway for the testicles. Therefore, if a malignant tumor develops, it is most likely to metastasize to the retroperitoneal para-aortic lymph nodes.

if only he had listented to his mother. She told him that girl was trash.

The most likely diagnosis based on the given information is embryonal carcinoma. This is supported by the elevated serum levels of hCG and AFP, which are both tumor markers associated with testicular germ cell tumors. Additionally, the microscopic appearance of the lesion shown in the image is consistent with embryonal carcinoma. Seminoma is another type of testicular germ cell tumor, but it typically presents with a painless mass that transilluminates on examination, which is not the case in this patient. Yolk sac tumor, Sertoli cell tumor, and Leydig cell tumor are less likely based on the clinical presentation and laboratory findings.

The most likely explanation for the patient's inability to achieve and/or maintain an erection after the prostatectomy is surgical damage to the parasympathetic nerves to the penis. These nerves are responsible for initiating the release of nitric oxide, which then leads to the production of cyclic guanosine monophosphate (cGMP) in the smooth muscle of the penis. cGMP is responsible for relaxing the smooth muscle and allowing increased blood flow into the penis, resulting in an erection. The drug Viagra helps correct his erectile dysfunction by inhibiting the breakdown of cGMP, allowing it to accumulate and maintain the erection.

Adenoma of GnRH producing cells of the hypothalamus can lead to precocious puberty because GnRH is responsible for the release of hormones that stimulate the production of sex hormones (such as LH and FSH) from the pituitary gland. If there is an adenoma (tumor) in the GnRH producing cells of the hypothalamus, it can cause an overproduction of GnRH, leading to early activation of the reproductive system and the onset of puberty at an abnormally young age.

The key microscopic feature seen in this tumor is a "fried egg appearance". This term refers to the characteristic appearance of the tumor cells, which have a central round nucleus resembling the yolk of a fried egg and a clear cytoplasm resembling the egg white. This feature is commonly seen in certain types of testicular germ cell tumors, such as seminomas. The other options, polygonal cells and spindle-shaped cells, are not associated with this specific tumor.

The most likely diagnosis in this case is prostate carcinoma. The patient's symptoms of difficulty urinating, urinary frequency, nocturia, and dribbling, along with the finding of an enlarged prostate on rectal examination, are consistent with prostate carcinoma. Additionally, the fact that a prostate biopsy was performed suggests that there was suspicion for malignancy. The microscopic appearance of the biopsy sample would provide further confirmation of the diagnosis.

Human chorionic gonadotropin (hCG) is the most likely hormone administered to the 1-year-old boy with undescended testes. hCG is a hormone that is normally produced during pregnancy and plays a role in the development of the male reproductive system. In the case of undescended testes, hCG can be used to stimulate the descent of the testes into the scrotum. This hormone helps to promote the production of testosterone, which is necessary for the normal development and functioning of the testes. Therefore, administering hCG can help correct the problem of undescended testes in this young boy.

Hypospadias is a condition characterized by the malformation of the urethral groove and urethral canal on the ventral surface of the penis. In hypospadias, the urethral opening is located on the underside of the penis instead of the tip. On the other hand, epispadias is a condition where the urethral opening is located on the dorsal surface of the penis. So, the correct answer states that malformation at the ventral surface is hypospadias, and at the dorsal surface is epispadias.