Difference between revisions of "Penis"
Jump to navigation
Jump to search
(→Micro) |
(→Specific conditions: +SCC penis) |
||
| Line 138: | Line 138: | ||
COMMENT: | COMMENT: | ||
A treponemal infection should be considered clinically. | A treponemal infection should be considered clinically. | ||
</pre> | |||
==Squamous cell carcinoma of the penis== | |||
===General=== | |||
*Not very common overall.<ref name=pmid24119832>{{Cite journal | last1 = Burt | first1 = LM. | last2 = Shrieve | first2 = DC. | last3 = Tward | first3 = JD. | title = Stage presentation, care patterns, and treatment outcomes for squamous cell carcinoma of the penis. | journal = Int J Radiat Oncol Biol Phys | volume = 88 | issue = 1 | pages = 94-100 | month = Jan | year = 2014 | doi = 10.1016/j.ijrobp.2013.08.013 | PMID = 24119832 }}</ref> | |||
*Most common form of penis cancer. | |||
**Non-squamous penis cancer only ~5% of cases.<ref name=pmid24292119>{{Cite journal | last1 = Moses | first1 = KA. | last2 = Sfakianos | first2 = JP. | last3 = Winer | first3 = A. | last4 = Bernstein | first4 = M. | last5 = Russo | first5 = P. | last6 = Dalbagni | first6 = G. | title = Non-squamous cell carcinoma of the penis: single-center, 15-year experience. | journal = World J Urol | volume = | issue = | pages = | month = Dec | year = 2013 | doi = 10.1007/s00345-013-1216-y | PMID = 24292119 }}</ref> | |||
Epidemiology:<ref name=pmid24119832/> | |||
*Median age ~ 67 years old. | |||
*Usually a good outcome - 5 year cause specific survival ~ 81%.<ref name=pmid24119832/> | |||
===Microscopic=== | |||
Features: | |||
*See ''[[squamous cell carcinoma]]''. | |||
Notes: | |||
*Usually grade 2.<ref name=pmid24119832/> | |||
===Sign out=== | |||
<pre> | |||
TIP OF PENIS, PARTIAL PENECTOMY: | |||
- INVASIVE SQUAMOUS CELL CARCINOMA, MODERATELY DIFFERENTIATED. | |||
-- SURGICAL MARGINS NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. | |||
-- PLEASE SEE TUMOUR SUMMARY. | |||
</pre> | </pre> | ||
Revision as of 18:19, 31 December 2013
The penis is occasionally afflicted by disease that the pathologist see.
It is afflicted by common skin pathologies.
Diseases
Inflammatory
- Phimosis.
- Paraphimosis.
- Balanoposthitis.
- Balanatis.
- Plasma cell balanitis.
- Balanitis xerotica obliterans.
- Balanitis circinata.
- Lipogranulomas.
Infectious
- HPV infection.
- HSV infection.
- Scabies.
- Pediculosis pubis.
- Syphilis.
- Gonorrhea.
- Lymphogranuloma venereum.
- Granuloma inguinale.
- Chancroid.
- Molluscum contagiosum.
- Filariasis - elephantiasis.
Other non-tumour
- Idiopathic scrotal calcinosis.
- Melanocytic lesions, esp. nevi.
- Fordyce spots.
Pre-cancerous
- Penile intraepithelial neoplasia (PIN).
- Paget disease (like extramammary Paget disease). (???)
Neoplastic
- Squamous cell carcinoma.
- Merkel cell carcinoma.
- Sebaceous carcinoma.
- Clear cell carcinoma.
- Basal cell carcinoma.
- Melanoma.
Others:
- Mesenchymal lesions - see: soft tissue lesions.
- Hematopoetic, e.g. lymphoma.
- Metastasis.
Specific conditions
Phimosis
General
- Cannot retract foreskin.
- This is a clinical diagnosis.
Microscopic
Features:[1]
- +/-Inflammation.
- Fibrosis.
Notes: Findings non-specific.
DDx - general:
- Squamous cell carcinoma - nuclear atypia.
- Balanitis xerotica obliterans - supeficial dermal fibrosis with thinned epidermis.
- Lichen planus - interface dermatitis with apoptotic bodies.
- Infection.
- Syphilis - plasma cells.
- Candidiasis.
- Zoon balanitis - plasma cells.
Sign out
FORESKIN, CIRCUMCISION: - SKIN WITH PATCHY MILD NONSPECIFIC INFLAMMATION. - NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.
FORESKIN, EXCISION: - KERATINIZED SQUAMOUS EPITHELIUM WITH PATCHY MILD NON-SPECIFIC SUBEPITHELIAL INFLAMMATION. - NEGATIVE FOR MALIGNANCY.
FORESKIN, CIRCUMCISION: - BENIGN KERATINIZED SQUAMOUS EPITHELIUM. - FIBROUS SUBEPITHELIAL TISSUE WITH MINIMAL PATCHY NONSPECIFIC INFLAMMATION. - NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.
Micro
The sections show skin with mild patchy chronic inflammation, consisting predominantly of lymphocytes, at the dermal-epidermal junction. The epidermis matures to the surface, has rete ridges and is of a normal thickness. Focally, parakeratosis is present. No significant nuclear atypia is identified.
Penile fibromatosis
Main article: Fibromatosis
- AKA Peyronie's disease.
General
- Prevalence ~5%.[2]
Treatment:
- Conservative versus surgery.
Gross
- Abnormal curvature of the penis, esp. in the erect state.
Microscopic
Features:[2]
- Tunica albuginea fibrosis.
Zoon balanitis
General
- Balanitis = inflammation of glands penis.
- Rare.
- Uncircumsized men.
Microscopic
Features:[3]
- Abundant plasma cells - key feature.
- Dermal atrophy.
- Spongiosis and intraepithelial lymphocytes.
- Tortuosity dermal blood vessels.
DDx:
- Syphilis - plasma cell-rich infiltrate.
- Balanitis xerotica obliterans.
Sign out
PENILE FORESKIN, CIRCUMCISION: - COMPATIBLE WITH PLASMA CELL BALANITIS (ZOON BALANITIS), SEE COMMENT. COMMENT: A treponemal infection should be considered clinically.
Squamous cell carcinoma of the penis
General
- Not very common overall.[5]
- Most common form of penis cancer.
- Non-squamous penis cancer only ~5% of cases.[6]
Epidemiology:[5]
- Median age ~ 67 years old.
- Usually a good outcome - 5 year cause specific survival ~ 81%.[5]
Microscopic
Features:
Notes:
- Usually grade 2.[5]
Sign out
TIP OF PENIS, PARTIAL PENECTOMY: - INVASIVE SQUAMOUS CELL CARCINOMA, MODERATELY DIFFERENTIATED. -- SURGICAL MARGINS NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY. -- PLEASE SEE TUMOUR SUMMARY.
See also
References
- ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 391. ISBN 978-0781765275.
- ↑ 2.0 2.1 Serefoglu, EC.; Hellstrom, WJ. (Dec 2011). "Treatment of Peyronie's disease: 2012 update.". Curr Urol Rep 12 (6): 444-52. doi:10.1007/s11934-011-0212-2. PMID 21818660.
- ↑ 3.0 3.1 Balato, N.; Scalvenzi, M.; La Bella, S.; Di Costanzo, L. (2009). "Zoon's Balanitis: Benign or Premalignant Lesion?". Case Rep Dermatol 1 (1): 7-10. doi:10.1159/000210440. PMID 20652106.
- ↑ Korenaga, D.; Kanematsu, T.; Watanabe, A.; Maehara, Y.; Kitano, S.; Sugimachi, K. (Feb 1991). "Clinical management of gastric cancer and concomitant esophagogastric varices.". J Surg Oncol 46 (2): 91-6. PMID 1992223.
- ↑ 5.0 5.1 5.2 5.3 Burt, LM.; Shrieve, DC.; Tward, JD. (Jan 2014). "Stage presentation, care patterns, and treatment outcomes for squamous cell carcinoma of the penis.". Int J Radiat Oncol Biol Phys 88 (1): 94-100. doi:10.1016/j.ijrobp.2013.08.013. PMID 24119832.
- ↑ Moses, KA.; Sfakianos, JP.; Winer, A.; Bernstein, M.; Russo, P.; Dalbagni, G. (Dec 2013). "Non-squamous cell carcinoma of the penis: single-center, 15-year experience.". World J Urol. doi:10.1007/s00345-013-1216-y. PMID 24292119.