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

Nodules in BPH

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

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

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

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

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

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

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

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

Prepubertal testis …just sertoli cells

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

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

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

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

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

Rim of the remaining testis A large lobulated seminoma

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

Seminoma Note the atypia and prominent nucleoli

Seminoma

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

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

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

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

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)

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