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DISEASES OF THE MALE GENITAL

TRACT AND LOWER URINARY TRACT

Section 11

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Case 1. NODULAR PROSTATIC HYPERPLASIA

50year old male

Admitted for urinary retention (started 1 yr ago)

Rectal exam: enlarged nodular and rubbery prostate

Slightly elevated prostate specific antigen

Transurethral resection prostatectomy (TURP) was performed

Specimen consists of multiple gray prostatic chips measuring

5cm in aggregate diameter

Microscopically:

 ±Glands were of various sizes (some cystically dilated andlined by two layers <inner columnar and outer cuboidal>)

 ± Cells had uniform nuclei and finely granular, homogenous

cytoplasm

 ±

Few lymphocytic aggregates in fibromuscular stroma

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NODULAR PROSTATIC HYPERPLASIA

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NODULAR PROSTATIC HYPERPLASIA

Benign prostatic

glands

Fibromuscular stroma

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NODULAR PROSTATIC HYPERPLASIA

** Round / ovoid nuclei (without nucleoli)

** cytoplasm

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Case 2. PROSTATIC CARCINOMA

65 year old male

Difficulty of urinating

Rectal exam: fixed, nodular stone hard prostatic mass

PSA levels markedly elevated

Transurethral biopsy: malignant glands

TURP with bilateral orchiectomy was performed

Specimen: consisted of several grayish yellow form to hard

prostatic chips

Microscopically:

 ± tumor was composed of closely-packed small sized glands

 ± individual cells infiltrating fibromuscular stroma

 ± Cells with prominent nucleoli

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PROSTATIC CARCINOMA

Malignant glands

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PROSTATIC CARCINOMA

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Case 3. SEMINOMA

45 year old male

Enlarging left scrotal mass (4 months duration)

PE: well-circumscribed movable doughy, slightly tender mass

Orchiectomy was done Specimen: well-circumscribed, ovoid, 8x5x5cm

Cut sections: grayish yellow solid homogenous surfaces

Microscopic exam:

 ± poorly demarcated lobules separated by fibrous septa withlymphocytic aggregates

 ± Tumor cells were polyhedral with abundant clear cytoplasm,

well-defined cell margins and large central hyperchromatic

nuclei

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SEMINOMA

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SEMINOMA

Fibrous septalobules

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Case 4. TRANSITIONAL CELL CARCINOMA

70 year old farmer

Painless hematuria

Ultrasound: mass in urinary bladder

Cytology of urine: presence of atypical cells

Radical cystectomy was performed

Gross findings: several red elevated excrescences along lateral

wall of urinary bladder

Microscopic section:

 ± tumor cells resembling urothelium arranged in fingerlike

papillae with a central core of loose fibrovascular tissue

 ± Hyperchromatic nuclei with occasional mitotic figures with

moderate to severe atypia and pleomorphism

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TRANSITIONAL CELL CARCINOMA

Papillae

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