Difference between revisions of "Penis"

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The '''penis''' is occasionally afflicted by disease that the pathologist see.
The '''penis''' is occasionally afflicted by disease that the pathologist sees


It is afflicted by common [[dermatopathology|skin pathologies]].
It is afflicted by common [[dermatopathology|skin pathologies]].
=Normal=
*Corpus spongiosum - fills with blood during erection.<ref>{{Cite journal  | last1 = Zhang | first1 = XH. | last2 = Melman | first2 = A. | last3 = Disanto | first3 = ME. | title = Update on corpus cavernosum smooth muscle contractile pathways in erectile function: a role for testosterone? | journal = J Sex Med | volume = 8 | issue = 7 | pages = 1865-79 | month = Jul | year = 2011 | doi = 10.1111/j.1743-6109.2011.02218.x | PMID = 21324096 }}</ref>
*Corpus cavernosum - around the urethra.
===Image===
<gallery>
Image:Gray1155.png | Cross section of penis. (WC)
</gallery>


=Diseases=
=Diseases=
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===Pre-cancerous===
===Pre-cancerous===
*Penile intraepithelial neoplasia (PIN).
*[[Penile intraepithelial neoplasia]] (PeIN).
*Paget disease (like [[extramammary Paget disease]]). (???)
*Paget disease (like [[extramammary Paget disease]]). (???)


===Neoplastic===
===Neoplastic===
*[[Squamous cell carcinoma]].
*[[Squamous cell carcinoma of the penis|Squamous cell carcinoma]].
*[[Merkel cell carcinoma]].
*[[Merkel cell carcinoma]].
*[[Sebaceous carcinoma]].
*[[Sebaceous carcinoma]].
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DDx - general:
DDx - general:
*[[Squamous cell carcinoma]] - nuclear atypia.
*[[Squamous cell carcinoma]] - nuclear atypia + invasion.
*[[Balanitis xerotica obliterans]] - supeficial dermal fibrosis with thinned epidermis.
*[[Penile intraepithelial neoplasia]] - nuclear atypia.
*[[Lichen sclerosus]] - supeficial dermal fibrosis with thinned epidermis.
*[[Lichen planus]] - interface dermatitis with apoptotic bodies.
*[[Lichen planus]] - interface dermatitis with apoptotic bodies.
*Infection.
*Infection.
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===Sign out===
===Sign out===
<pre>
FORESKIN, CIRCUMCISION:
- SKIN WITH PATCHY MILD NONSPECIFIC INFLAMMATION.
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.
</pre>
<pre>
<pre>
FORESKIN, EXCISION:
FORESKIN, EXCISION:
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   SUBEPITHELIAL INFLAMMATION.
   SUBEPITHELIAL INFLAMMATION.
- NEGATIVE FOR MALIGNANCY.
- NEGATIVE FOR MALIGNANCY.
</pre>
<pre>
FORESKIN, EXCISION:
- KERATINIZED STRATIFIED SQUAMOUS EPITHELIUM.
- FIBROUS SUBEPITHELIAL TISSUE.
- NEGATIVE FOR MALIGNANCY.
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</pre>


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FORESKIN, CIRCUMCISION:
FORESKIN, CIRCUMCISION:
- BENIGN KERATINIZED SQUAMOUS EPITHELIUM.
- BENIGN KERATINIZED SQUAMOUS EPITHELIUM.
- FIBROUS SUBEPITHELIAL TISSUE WITH MINIMAL PATCHY NONSPECIFIC INFLAMMATION.
- MILDLY FIBROUS SUBEPITHELIAL TISSUE WITH MINIMAL PATCHY NONSPECIFIC INFLAMMATION.
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.
- NEGATIVE FOR DYSPLASIA AND NEGATIVE FOR MALIGNANCY.
</pre>
</pre>


====Micro====
====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 melanocytic lesions are seen. No significant nuclear atypia is identified.
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.
 
=====Thinned epidermis=====
The sections show skin with mild patchy chronic inflammation, consisting predominantly of
lymphocytes, at the dermal-epidermal junction. Eosinophils are not readily apparent.
 
The epidermis matures to the surface; however, it is thinned and focally flattened
appearing. No hyperkeratosis or parakeratosis is apparent. The superficial dermis is
minimally hyalinized focally. No significant nuclear atypia is identified.
 
======Alternate======
The sections show skin with mild patchy chronic inflammation, consisting predominantly of
lymphocytes, at the dermal-epidermal junction. Eosinophils are not readily apparent.
The epidermis matures to the surface; however, it is focally thinned and focally flattened.
No significant hyperkeratosis or parakeratosis is apparent. The superficial
dermis shows no apparent fibrosis. No significant nuclear atypia is identified.


==Penile fibromatosis==
==Penile fibromatosis==
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*Balanitis = inflammation of glands penis.
*Balanitis = inflammation of glands penis.
*Rare.
*Rare.
*Uncircumsized men.
*Uncircumsized men.<ref name=pmid7884748>{{Cite journal  | last1 = Yoganathan | first1 = S. | last2 = Bohl | first2 = TG. | last3 = Mason | first3 = G. | title = Plasma cell balanitis and vulvitis (of Zoon). A study of 10 cases. | journal = J Reprod Med | volume = 39 | issue = 12 | pages = 939-44 | month = Dec | year = 1994 | doi =  | PMID = 7884748 }}</ref>
*Analogous to [[plasma cell vulvitis]] in women.
 
Treatment:<ref name=pmid7884748/>
*Circumcision.
*Corticosteroids.


===Microscopic===
===Microscopic===
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*[[Syphilis]] - plasma cell-rich infiltrate.
*[[Syphilis]] - plasma cell-rich infiltrate.
*[[Balanitis xerotica obliterans]].  
*[[Balanitis xerotica obliterans]].  
====Images====
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895202/figure/F2/ Zoon balanitis (nih.gov)].<ref name=pmid20652106/>
<gallery>
Image: Penis Zoons Balanitis MP 4 PA.jpg|Note the flattened 'lozenge' keratinocytes separated by spongiosis (SKB).
Image: Penis Zoons Balanitis MP 3 PA.jpg|The epidermis is very atrophic in this example but shows 'lozenge' keratinocytes and spongiosis (SKB).
Image: Penis Zoon Balanitis SNP.jpg||This example might at first glance appear to be a lichenoid balanitis but the thin layer of epidermis is actually intact (SKB).
</gallery>


===Sign out===
===Sign out===
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A treponemal infection should be considered clinically.
A treponemal infection should be considered clinically.
</pre>
</pre>
==Squamous cell carcinoma of the penis==
{{Main|Squamous cell carcinoma of the penis}}


=See also=
=See also=
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