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Difference between revisions of "Penis"
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The '''penis''' is occasionally afflicted by disease that the pathologist | 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 ( | *[[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. | ||
*[[ | *[[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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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> | ||
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====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 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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====Images==== | ====Images==== | ||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2895202/figure/F2/ Zoon balanitis (nih.gov)].<ref name=pmid20652106/> | *[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=== | ||