PATHOLOGY PICTURES

Male genital pathology

62 year old male

SCC of the penis, spreading through the vessels of the corpora cavernosa

Malignant penile carcinoma

59 year old male with haemochromatosis and cirrhosis

Testicular atrophy

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Atrophic testis

Low power: tunica albuginea (long arrow); seminiferous tubules (short arrow)

High power: Leydig cells (long arrow); atrophic tubules (short arrows); thickened basement membrane; lack of spermatogenesis

A: normal testis

B: testicular atrophy tubules have Sertoli cells but no spermatogenesis; thickened basement membrane; apparent increase in interstitial Leydig cells

30 year old man with dystrophia myotonica

Advanced testicular atrophy

Epididymitis and orchitis

71 year old male with prostatic hyperplasia

Chronic granulomatous epididymo-orchitis

Blue arrows: cream nodules comprising lipid-laden macrophages

Black arrows: hydrocoele

Tuberculous epididymo-orchitis

Predominantly affecting the epididymis (arrows)

Tertiary syphilis

Gumma (arrows) of the testis

Multiple irregular areas of necrosis surrounded by a zone of dense fibrosis

No recognisable testicular tissue remains

Haemorrhagic infarction of testis due to torsion of spermatic cord

Testis which has recently undergone infarction

Low power: tunica albuginea (long arrow); infarcted tubule (small arrow)

High power: necrotic seminiferous tubules (long arrows); oedema separating tubules (short arrows)

Haemorrhagic necrosis of the testis and epididymis due to torsion of the spermatic cord

Testicular torsion

Torsion of the testicular appendix

Bilateral cysts of epididymis

40 year old male

Seminoma of the testis

Homogeneous cream colour

Testicular tumours are usually a mixture of seminoma and teratoma components

Seminoma of the testis

Fairly well circumscribed, pale, fleshy, homogeneous mass

Embryonal carcinoma

Haemorrhagic mass

Choriocarcinoma

Small size; marked haemorrhage and necrosis

17 year old male

Malignant teratoma of the testis

Varied macroscopic appearance from one area to another

Immature testicular teratoma

Low power: tunica (A); residual seminiferous tubules (B); varied picture within and between fields

High power: immature mesenchyme (A); immature cartilage (B); seminoma (C) seminoma can form a component of a mixed germ cell tumour

High power view of seminoma component: tumour cells (arrows) have large central nuclei and clear cytoplasm; fibrous connective tissue septae infiltrated with chronic inflammatory cells (arrowheads)

Man aged 35 with ‘cannon ball’ secondaries in the lungs and a positive pregnancy test

Immature teratoma of the testis with a choriocarcinoma component

Haemorrhagic necrosis of choriocarcinoma component (characteristic due to tumour cells invading blood vessels)

Homogenous white areas: seminoma

Teratoma of the testis

Variegated cut surface with cysts

Mature teratoma

Immature teratoma

72 year old male

Hydrocoele (blue arrows) with atrophic testis (red arrows)

6 year old male

Hydrocoele of the spermatic cord

Chronic haematocoele (blue arrows) with testicular atrophy (red arrows)

Man aged 58

Varicocoele (blue arrows)

Appendix of epididymis (red arrows)

Hydatid of Morgagni (black arrow) with twisted pedicle

72 year old male with DM complicating haemochromatosis

Prostatic abscess

Blue arrows: pyogenic membrane (abscess contents removed)

83 year old male

Nodular hyperplasia of the prostate and muscle hypertrophy and trabeculation of the bladder

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Low power: increased stroma and proliferated glands (arrows)

High power: double layer of nuclei (long arrows); regular nuclei and inconspicuous nucleoli (arrowheads)

Prostatic hyperplasia

Hypertrophy of bladder muscle

Cystitis

Bilateral hydroureter and hydronephrosis

Suppurative pyelonephritis

BPH

Well-define nodules compress the urethra into a slit-like lumen

Histology: nodules of hyperplastic glands on both sides of the urethra

Carcinoma in the posterior prostate

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Adenocarcinoma of the prostate

Low power: proliferation of closely-packed small glands; infiltrating into surrounding stroma

High power: glands are closely applied (long arrows); enlarged, hyperchromatic nuclei; nuclei are irregularly arranged in the cells (arrowheads)

Poorly differentiated prostatic adenocarcinoma

Almost complete loss of the glandular architecture, pleomorphic nulei, prominent nucleoli

Advanced carcinoma of the prostate

Adenocarcinoma of the prostate

Lower left is posterior aspect (where carcinomatous tissue is)

Solid white tissue of cancer unlike spongy appearance of benign peripheral zone