021015 male pathology testis,adnexa

Question 1

tunica vaginalis

Answer 1

potential space that is an outpouching from peritoneum

Question 2

crytorchidism

Answer 2

one or both testes fail to descend into scrotum (the process depends on hCG)

Question 3

epididymitis-causes?

Answer 3

UTI, or STI

gorrhea, chlamydia, TB, E coli, Pseudomonas

Question 4

Prehn’s sign

Answer 4

elevation of scrotum decreases pain –positive in epididymitis

Question 5

orchitis

Answer 5

painful inflammatory condition of testis

caused by TB, mumps, HIV, syphilis, extension from epididymitis

Question 6

torsion of testis

Answer 6

twisting of spermatic cord cuts off venous/arterial blood supply, causing ischemia of testis

Question 7

sudden onset of testicular pain, negative Prehn’s sign

Answer 7

torsion of testis

Question 8

risk factors for testicular cancer

Answer 8

cryptorchid testicle (most common)
testicular feminization (female phenotype)
Klinefelter's syndrome (XXY)

Question 9

clinical findings for testicular cancer

Answer 9

unilateral, painless enlargement of testis

Question 10

testicular tumors-germ cell type

Answer 10

seminoma
mixed
non-seminomatous

Question 11

precursor for testicular germ cell tumors

Answer 11

ITGCN (non-invasive)

Question 12

types of non-seminomatous germ cell testicular tumors

Answer 12

embryonal cancers
yolk sac tumor
choriocarcinoma
teratoma (matture or immature)

Question 13

what pecent of pts with ITGCN develop invasive germ cell tumor within 7 yrs?

Answer 13

more than 70%

Question 14

ITGCN

Answer 14

40% of cases are bilateral

spermatogenesis is absent

Question 15

histology of ITGCN

Answer 15

nucleus and cyto are enlarged
irreguarly shaped nucleus
prominent nucleoli

Question 16

markers for seminoma

Answer 16

alpha fetoprotein (AFP) is normal
beta hCG can be elevated

Question 17

key finding for seminoma on histology

Answer 17

lymphocyte infiltrate

Question 18

how are non-seminomatous germ cell tumors diff from seminomas

Answer 18

non-seminomatous germ cell tumors of testis are NOT radiosensitive

Question 19

embroynonal carcinoma markers

Answer 19

serum AFP normal

beta hCG elevated in 60%

Question 20

embryonal carcinoma histology

Answer 20

large cells with vesicular (clumping and clearing) nuclei

GLANDULAR STRUCTURES

Question 21

most common germ cell tumor in infants and children

Answer 21

yolk sac tumor (endodermal sinus tumor)

Question 22

marker for yolk sac tumor

Answer 22

elevated serum alpha fetoprotein

Question 23

Schiller-Duval bodies (central vessel rimmed by loose connec tis that in turn is lined by malignant epithelium, all within a cystic space)

Answer 23

yolk sac tumor

Question 24

teratoma

Answer 24

MATURE form: somatic type tissues that can include intestine type glands, respiratory epithelium, cartilage, muscle, sq epithelium

IMMATURE: worse outcome

Question 25

choriocarcinoma markers

Answer 25

serum beta hCG elevated
poorer prognosis
stain hCG positive

Question 26

most common testis tumor over age 60

Answer 26

lymphoma

Question 27

epididymis-most common tumor

Answer 27

adenomatoid tumor (ALWAYS BENIGN)
probable mesothelial origin

Question 28

most common cause of scrotal swelling

Answer 28

hydrocele (fluid in tunica vaginalis)

Question 29

vasitis nodosa

Answer 29

sperm containing ductules extend into stroma