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Pathology - Urethral disorders
Urethritis • Typically induced by sexually transmitted infections. • Categorized as gonococcal and non-gonococcal urethritis. • Non-gonococcal urethritis is more prevalent, with the majority of cases attributed to C. trachomatis. Patients commonly report a sense of urethral pruritus. Gonococcal urethritis results from infection with Neisseria gonorrhoeae. Patients typically exhibit a more purulent exudate and dysuria. Gram staining of urethral discharge can identify N. gonorrhoeae as intracellular Gram-negative diplococci. If these organisms remain undetected, however a significant presence of neutrophils confirms urethritis, non-gonococcal urethritis is inferred. Detection of C. trachomatis is typically accomplished by molecular techniques, as culture is both slow and inaccurate.
Prostatic urethral polyp • Lesion of the prostatic urethra comprising prostatic epithelium. • Commonly manifests as haematuria. • Morphologically, they are papillary lesions protruding into the prostatic urethra. • Histologically, they consist of densely packed prostatic-type glands enveloped by urothelium.
Urethral caruncle • A rather prevalent polypoid lesion located in the distal urethra of women. • Exhibits dysuria and intermittent bleeding. • The caruncle appears as a polypoid mass at the urethral meatus. • Histological examination reveals a dense infiltrate of inflammatory cells abundant in blood vessels, covered by hyperplastic epithelium.
Urethral carcinomas • These neoplasms are infrequent, yet more prevalent in females. • Typically diagnosed at an advanced stage with a dismal prognosis. • The majority are squamous cell carcinomas (70%) originating in the distal urethra near the meatus. • The remaining cases consist of urothelial carcinomas (20%) or adenocarcinomas (10%), typically originating in the proximal urethra.
Malignant melanoma is uncommon, however thoroughly documented in the urethra. • They manifest as polypoid or ulcerated masses in the urethra. Histologically, they consist of aberrant epithelioid or spindle-shaped cells. Often amelanotic, which may result in diagnostic challenges. The immunohistochemical reactivity of malignant cells for melanocytic markers (S100, HMB-45, Melan-A) aids in confirming the diagnosis.
Urethritis • Typically induced by sexually transmitted infections. • Categorized as gonococcal and non-gonococcal urethritis. • Non-gonococcal urethritis is more prevalent, with the majority of cases attributed to C. trachomatis. Patients commonly report a sense of urethral pruritus. Gonococcal urethritis results from infection with Neisseria gonorrhoeae. Patients typically exhibit a more purulent exudate and dysuria. Gram staining of urethral discharge can identify N. gonorrhoeae as intracellular Gram-negative diplococci. If these organisms remain undetected, however a significant presence of neutrophils confirms urethritis, non-gonococcal urethritis is inferred. Detection of C. trachomatis is typically accomplished by molecular techniques, as culture is both slow and inaccurate.
Prostatic urethral polyp • Lesion of the prostatic urethra comprising prostatic epithelium. • Commonly manifests as haematuria. • Morphologically, they are papillary lesions protruding into the prostatic urethra. • Histologically, they consist of densely packed prostatic-type glands enveloped by urothelium.
Urethral caruncle • A rather prevalent polypoid lesion located in the distal urethra of women. • Exhibits dysuria and intermittent bleeding. • The caruncle appears as a polypoid mass at the urethral meatus. • Histological examination reveals a dense infiltrate of inflammatory cells abundant in blood vessels, covered by hyperplastic epithelium.
Urethral carcinomas • These neoplasms are infrequent, yet more prevalent in females. • Typically diagnosed at an advanced stage with a dismal prognosis. • The majority are squamous cell carcinomas (70%) originating in the distal urethra near the meatus. • The remaining cases consist of urothelial carcinomas (20%) or adenocarcinomas (10%), typically originating in the proximal urethra.
Malignant melanoma is uncommon, however thoroughly documented in the urethra. • They manifest as polypoid or ulcerated masses in the urethra. Histologically, they consist of aberrant epithelioid or spindle-shaped cells. Often amelanotic, which may result in diagnostic challenges. The immunohistochemical reactivity of malignant cells for melanocytic markers (S100, HMB-45, Melan-A) aids in confirming the diagnosis.
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