IPLab:Lab 2:Atrophy

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Clinical Summary[edit]

This 74-year-old man was found to have carcinoma of the prostate six years prior to his death. The serum prostate-specific antigen (PSA) level was 9.7 ng/ml. His plasma acid phosphatase level on repeated tests ranged from 2 to 4 IU/L. X-rays revealed metastatic lesions in the patient's pelvis and vertebral column. He refused to have an orchiectomy and was placed on estrogen therapy (diethylstilbestrol).

The patient's terminal admission was for renal failure. The tumor had grown into the floor of the urinary bladder causing obstruction of the ureters at their entrance to the bladder. The patient developed acute hydronephrosis which was drained by nephrostomies. Eventually, infection developed in the kidneys resulting in Gram-negative sepsis and death.


Virtual Microscopy[edit]

Testis: Atrophy[edit]

Normal Testis[edit]

Study Questions[edit]

Additional Resources[edit]


Journal Articles[edit]


Prostate-specific antigen (PSA) is a product of prostate epithelium which is normally emitted in the semen. Normal men have very low levels of PSA circulating in their blood. PSA levels are slightly raised in men who have prostatic hyperplasia but are greatly elevated in men who have prostate cancer (the level increases proportionately to the severity of the cancer). PSA is a useful marker for both localized and metastatic prostate cancer.

A PSA level above 4 ng/ml should lead to suspicion of prostate cancer.

Plasma acid phosphatase is a useful marker for metastatic prostate cancer but not for localized prostate cancer.

A normal level should be less than 0.8 IU/L.

An orchiectomy is the surgical removal of a testicle. The growth of a prostatic carcinoma is androgen-dependent. Removal of the testes (hence removal of androgens) can lead to tumor regression--although usually temporary.

Since prostatatic carcinomas are androgen-dependent, estrogen therapy helps to reduce output of testosterone thereby slowing tumor progression.

Renal failure is the severe reduction of renal function and often leads to reduced urinary output.

Hydronephrosis is dilation of the renal pelvis and atrophy of the cortex due to increase pressure from retained urine.

A nephrostomy is the creation of a permanent opening directly into the renal pelvis to allow the drainage of urine.

Gram-negative sepsis is a systemic inflammatory response caused by the presence of Gram-negative bacteria and their endotoxins in the blood. The microbes usually enter the bloodstream from an area of localized infection. Gram-negative sepsis is the leading cause of septic shock--hence, also known as "endotoxic shock." Septic shock is a syndrome of inflammatory responses which can lead to severe hypotension, multiple organ system failure, and death.

Atherosclerosis is the deposition of lipid into the intima of arteries, resulting in narrowing of the vessel lumen.