DISEASES OF THE MALE GENITAL

TRACT AND LOWER URINARY TRACT

Section 11
Case 1. NODULAR PROSTATIC HYPERPLASIA
• 50 year 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 and
lined by two layers <inner columnar and outer cuboidal>)
– Cells had uniform nuclei and finely granular, homogenous
cytoplasm
– Few lymphocytic aggregates in fibromuscular stroma
NODULAR PROSTATIC HYPERPLASIA
NODULAR PROSTATIC HYPERPLASIA

Fibromuscular stroma

Benign prostatic
glands
 NODULAR PROSTATIC HYPERPLASIA

** Round / ovoid nuclei (without nucleoli)

** ↑ cytoplasm
 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
PROSTATIC CARCINOMA

Malignant glands
PROSTATIC CARCINOMA
 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 with
lymphocytic aggregates
– Tumor cells were polyhedral with abundant clear cytoplasm,
well-defined cell margins and large central hyperchromatic
nuclei
SEMINOMA
 SEMINOMA

lobules
Fibrous septa
 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
TRANSITIONAL CELL CARCINOMA

Papillae
TRANSITIONAL CELL CARCINOMA