Pathology
Male Genital Tract
Male genital tract pathology for MBBS and NEET-PG: testicular germ cell tumours, cryptorchidism, benign prostatic hyperplasia and prostate and penile carcinoma, mapped to NMC codes PA29.1 to PA29.5.
MedNext Academy | 3 min read
Male Genital Tract
Male genital tract pathology for MBBS and NEET-PG: testicular germ cell tumours, cryptorchidism, benign prostatic hyperplasia and prostate and penile carcinoma, mapped to NMC codes PA29.1 to PA29.5.
This chapter covers pathology of the male genital tract. It includes testicular germ cell tumours and their markers, cryptorchidism, benign prostatic hyperplasia, prostatic adenocarcinoma with Gleason grading and PSA, and carcinoma of the penis.
High-yield: Male Genital Tract
- Testicular tumours are mostly germ cell tumours, divided into seminomatous and non-seminomatous types.
- Seminoma is the most common testicular tumour, radiosensitive and with a good prognosis.
- Non-seminomatous germ cell tumours include embryonal carcinoma, yolk sac tumour, choriocarcinoma and teratoma.
- Alpha-fetoprotein is raised in yolk sac tumours, and beta-hCG in choriocarcinoma and some germ cell tumours.
- Cryptorchidism, the failure of testicular descent, increases the risk of germ cell tumours and of infertility.
- Benign prostatic hyperplasia arises in the periurethral transition zone and causes bladder outflow obstruction.
- Benign prostatic hyperplasia is androgen (dihydrotestosterone) dependent and does not predispose to cancer.
- Prostatic adenocarcinoma arises mostly in the peripheral zone and is often detected on digital rectal examination.
- Prostate-specific antigen is used to screen for and monitor prostate cancer, though it is not entirely specific.
- The Gleason grading system scores prostate cancer by its glandular architecture and predicts prognosis.
- Prostate cancer characteristically metastasises to bone, producing osteoblastic (sclerotic) lesions.
- Carcinoma of the penis is a squamous cell carcinoma linked to poor hygiene and human papillomavirus, and is rare where circumcision is common.
- The bladder, prostate and rectum are common local sites of spread for advanced genitourinary cancers.
- Germ cell tumours of the testis usually present as a painless, firm testicular swelling.
Prostate: hyperplasia versus carcinoma
- **BPH:** Transition (periurethral) zone; androgen-dependent; causes outflow obstruction; not premalignant.
- **Carcinoma:** Peripheral zone; adenocarcinoma; Gleason graded; PSA marker.
- **Spread:** Prostate cancer metastasises to bone as osteoblastic lesions.
- **Testis markers:** AFP (yolk sac), beta-hCG (choriocarcinoma).
NMC competencies in this chapter
- **PA29.1:** Pathology, morphology and spread of testicular tumours
- **PA29.2:** Pathogenesis, pathology and complications of benign prostatic hyperplasia
- **PA29.3:** Pathogenesis, grades, spread and staging of carcinoma of the prostate
- **PA29.4:** Pathogenesis, pathology and natural history of carcinoma of the penis
- **PA29.5:** Pathogenesis, pathology and complications of cryptorchidism
Frequently Asked Questions
What is the most common testicular tumour?
Seminoma, a germ cell tumour that is radiosensitive and carries a good prognosis.
Where do benign prostatic hyperplasia and prostate cancer arise?
Benign prostatic hyperplasia arises in the transition zone around the urethra, while prostatic carcinoma arises mostly in the peripheral zone.
How does prostate cancer spread to bone?
It characteristically produces osteoblastic or sclerotic bone metastases, especially in the vertebrae and pelvis.
Why is cryptorchidism important?
An undescended testis carries an increased risk of germ cell tumours and of infertility.
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