2. 70 year old man with urinary obstruction
Discrete, large nodules
Avg wt of TURP – 100 grams
Periurethral transitional
5% peripheral zone involved
Bulging nodules soft, pink, and oozing prostatic fluids
Stromal hypertrophy with increased gray/tan, firm tissue
Thickened urinary bladder wall with trabeculation
Hydronephrosis or acute retention with secondary urinary tract infection and even azotemia or uremia
Nodular Hyperplasia

3. 70 year old man with an elevated PSA (10x greater than normal)
with a firm nodule palpated on rectal exam
prostate carcinoma
Rock hard on digital rectal exam
Gritty and firm
White-yellow area, nonbulging
Poorly delineated, asymmetric
Most often in peripheral location
More easily felt than seen, often undetectable if tumor small
Loss of basal layer – 34 betaE12/CK903 negative
Pattern depends on Gleason score, small or medium sized glands
Cribriform (gland in gland formation) (Gleason 3)
Diffuse single cell infiltration with or without necrosis (Gleason 5)
Significantly enlarged nuclei
Prominent nucleoli:>3 microns specific for CA,>1 micron suggestive
Glands too many, too small, too crowded

4. One year old boy with a testicular mass
testicular torsion
First year of life, also in puberty due to trauma or violent movement; affected testis painful swollen lying higher than normal
Torsion without infarct infertility in proportion to duration
Treat: untwist and fix testis to dartos muscle, or orchiectomy
Up to 6 hr – venous congestion and interstitial hemorrhage
2-3 d neutrophils in capillaries
4 days – hemorrhagic infarct, coagulative necrosis

5. 40 year old man with testicular mass
seminoma