Male Genito-Urinary Pathology

Prostate

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Image 0001

This prostate gland has been sectioned perpendicular to the urethra to reveal two large bulging masses of benign hyperplasia, one on either side of the urethra, which project above the cut surface of the surrounding tissue. This is the typical appearance of benign hyperplasia causing bladder outlet obstruction. Note how these bulging nodules can compress the urethra.

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Image 0002

This gross photograph is of a slice of resected prostate gland which has been sectioned perpendicular to the urethra. The triangular hole in the center of the specimen is the urethra and the ruler is adjacent to the rectal surface of the gland. This gland contains carcinoma which can be seen as a yellowish mass in the lower right part of the gland (between about "8" and "10" on the ruler). Generally carcinomas arise in the periphery of the prostate, far from the urethra, where they can be felt by the examining finger.

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Image 0068

This photomicrograph shows the appearance of a low grade carcinoma of the prostate (contrast with the normal large prostatic duct in the top right corner). The glands are tightly packed together, but it is difficult to recognize definite invasive growth at this magnification. This appearance can be difficult to recognize as cancer, particularly in small needle biopsies.

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Image 0004

This photomicrograph shows a very high grade prostate carcinoma. The malignant cells are diffusely infiltrating the muscular stroma of the prostate, without definite gland formation. This highly invasive appearance correlates with aggressive behavior of the cancer and a high risk of metastasis.

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Image 0005

Perineural invasion is very common in prostate carcinoma, frequently involving the numerous autonomic nerves which run in the capsule of the prostate. The nerve in this picture contains a cluster of nerve cell bodies and a wavy collection of nerve fibers; the carcinoma forms malignant glands which invade into the sheath of the nerve.

Testis

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Image 0006

This photograph shows a bisected testis with attached epididymis and spermatic cord. The testis is the oval brown structure next to the ruler. Just below the testis and to the left is a dilated and scarred epididymis containing gelatinous brown and yellowish debris, the result of chronic epididymitis.

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Image 0007

This testis has been completely replaced by a seminoma. It has been bisected to reveal the typical soft, tan, fleshy, and lobular appearance of the tumor. The area of tumor with darker coloration contains congested blood vessels.

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Image 0008

There is only a slight amount of normal testis remaining in this bisected specimen, forming a rim of tan or brown tissue around the large, soft, ragged, hemorrhagic mass, which is an embryonal carcinoma.

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Image 0070

This slide shows the typical histologic appearance seminoma. Seminoma is composed of cells with abundant clear cytoplasm, central oval nuclei, and prominent nucleoli growing in sheets or in a delicate lobular pattern. There is frequently an infiltrate of lymphocytes in seminomas, as in this case. The cells in seminomas resemble to a certain extent the normal spermatogonia.

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Image 0071

Embryonal carcinoma is composed of larger more pleomorphic (variable appearing) cells with dense cytoplasm, very large oval or irregularly shaped nuclei, prominent nucleoli, and clumped chromatin. The cells of embryonal carcinoma often form primitive epithelial structures surrounding clefts and spaces.

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Image 0010

This testis has been sectioned to reveal a small, dark red (hemorrhagic) tumor mass, which proved to be a choriocarcinoma.

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Image 0011

This photomicrograph shows the typical histology of a choriocarcinoma. The neoplasm resembles normal placenta with large multi-nucleated syncytial cells intermingled with clusters of polygonal cells resembling cytotrophoblasts. One huge syncytial cell weaves its way through the tissue across the entire field of this photograph. These tumors readily invade blood vessels, mimicking the behavior of normal placental cells when they implant in the uterus and tap into the maternal blood supply.