1. Pathology of the Urogenital Tract Male Genital Tract March 24, 2014

2. Case 1

3. Q1 Name the organ. Describe the normal histology.

4. Q2. Name the organ. Describe the normal histology

5. Q3 Describe the normal histology (high power)

6. Case 2

7. HISTORY: A 32-year-old previously healthy man presents with a painless mass in his left testicle. He noticed it about 1 month ago. It was not getting smaller so he sought medical attention. VITAL SIGNS: 135/80 HR 80 RR 15 T 98° PHYSICAL EXAMINATION: Palpable, mobile 3 cm non-tender mass is present in the left testicle. Exam is otherwise unremarkable. There is no inguinal lymphadenopathy.

8. Q1: What is the main clinical problem and differential diagnosis?

9. LAB TESTS Chest X-ray is normal Serum AFP and HCG are normal

10. Q2: Describe gross findings

11. Q3: Describe the pathologic changes

12. Q4:What is your diagnosis?

13. Q5: List the key clinical and pathologic features of this tumor.

14. Case 3

15. HISTORY: 67-year-old male has nocturia, urinary hesitancy (difficulty in starting and stopping urine flow), “weak” urine stream, and dribbling at the end of urination. PHYSICAL EXAMINATION: On digital rectal exam the prostate gland is enlarged and non-tender. There are no palpable masses.

16. Q1: What is the clinical problem and list your differential diagnosis?

17. LAB TESTS: Prostate specific antigen (PSA) is within normal limits for a man this age.

18. Q2:Describe gross findings

19. Q3: Identify organ and describe the pathologic changes

20. Q4: What is your diagnosis?

21. Q5: What complications may occur because of this problem?

23. Q6: What hormone is related to this process?

24. Case 4

25. HISTORY: A 72-year-old man presents with back pain. It is constant and exacerbated by movement. The pain often keeps him up at night. PHYSICAL EXAMINATION: There is tenderness over the lower spine. Neurologic exam is normal. A single, hard prostatic nodule is palpated on digital rectal exam. No lymphadenopathy is noted.

26. Q1: What are the main clinical problems and differential diagnosis ?

27. RADIOGRAPHY: Osteoblastic vertebral lesions are noted on x-rays of the spine. LAB TESTS: PSA 353.46 H ( 0.0 - 4.0 NG/ML)

28. Transrectal Biopsy of Prostate

29. Q2: Describe the gross findings

30. Q3:Identify organ and describe the pathologic changes

31. Q4. What is your diagnosis?

32. Q5: What is a Gleason grade?

33. Q6: What is a Gleason score?

34. Q7: Which genetic changes may occur in this process?

35. Q8: Correlate the clinical and radiographic findings with the pathologic diagnosis:

37. Case 5

38. HISTORY: 62-year-old man presents with hematuria. He has no difficulty in voiding and no flank or back pain. He has a history of smoking. PHYSICAL EXAMINATION: Unremarkable. LAB TESTS: Urinalysis 4+ blood 1+protein 50-100 red blood cells/high power field

39. Q1: What is the main clinical problem?

40. Q2: What is the clinical differential diagnosis?

41. Cystoscopic Findings Urine Cytology Q3: Describe the following findings:

42. Q4: Identify organ and describe the pathologic changes

43. Q5: What is your diagnosis?

45. Q6: What are the epidemiologic predisposing factors to this process?