男性生殖系统病理改变june172013.pdfVIP

男性生殖系统病理改变 June 17, 2013 陈俭讲师 病理学与病理生理学系 浙江大学医学部 Tel: cj@zju.edu.cn 男性生殖系统主要疾病 • 前列腺炎 • 前列腺增生症 • 前列腺癌 • 睾丸扭转 • 精原细胞瘤 • 阴茎鳞状细胞癌 • 男性乳腺发育 Adult prostate. The normal prostate contains several distinct regions, including a central zone (CZ), a peripheral zone (PZ), a transitional zone (TZ), and a periurethral zone. Most carcinomas arise from the peripheral glands of the organ and may be palpable during digital examination of the rectum. Nodular hyperplasia, in contrast, arises from more centrally situated glands and is more likely to produce urinary obstruction early than is carcinoma. 前列腺炎（prostatitis ） • 急性或慢性炎症，继发于膀胱或泌尿道感染 • 病原菌多为大肠杆菌 • 临床表现： – 尿频、尿急，排尿困难，腰骶部疼痛 – 前列腺肿大或触痛 – 发热，白细胞增多 • 病理改变： – 中性粒细胞弥漫浸润，间质充血水肿，小脓肿形成 – 淋巴细胞和浆细胞浸润 – 肉芽肿性炎 This is chronic prostatitis. Numerous small dark blue lymphocytes are seen in the stroma between the glands. There may be a bacterial agent accompanying this inflammation, and cystitis or urethritis may also be present. However, more commonly, chronic prostatitis is abacterial and there is no history of urinary tract infection. The serum prostate specific antigen may be slightly elevated. 前列腺增生症（benign prostatic hyperplasia ） • 前列腺的良性病变，前列腺上皮和间质增生，结节状前列腺增生或前 列腺肥大。 • 50岁以上男性常见，与体内激素水平变化有关 • 病理变化： – 结节状增大，与周围正常组织分界不清 – 上皮呈乳头状，形成皱襞，腔内含有淀粉小体 • 临床病理联系： – 尿道梗阻，排尿困难等症状 – 尿潴留，膀胱扩张，尿路感染，肾盂积水，肾衰竭 A normal prostate gland is about 3 to 4 cm in diameter. This prostate is enlarged due to prostatic hyperplasia, which appears nodular. Thus, this condition is termed either BPH (benign prostatic hyperplasia) or nodular prostatic hyperplasia. Microscopically, benign prostatic hyperplasia can involve both glands and stroma, though the former i