Male Pathology (Testes Penis Scrotum) Flashcards Preview

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Flashcards in Male Pathology (Testes Penis Scrotum) Deck (26):

what types of cells are located in the seminiferous tubules? what cells surround the capsule in the interstitium?

spermatogonia (germ cells) and Sertoli cells; Leydig cells


cryptorchidism: pathogenesis, increased risk for what

undescended testis (one or both) --> impaired spermatogenesis (since sperm develop best at temperatures <37 C); germ cell tumors


orchitis: pathogenesis

inflammation or infection of the testis, complicates 20% of adult mumps infections


major risk factors for testicular cancer

cryptorchidism, Klinefelter syndrome (47,XXY)


seminoma: presentation, characteristics, histology, prognosis

malignant, painless, homogenous testicular enlargement; most common testicular tumor, most common in 3rd decade, never in infancy
histology: large cells in lobules with watery cytoplasm and "fried egg" appearance
prognosis: radiosensitive, excellent prognosis


list the 4 nonseminomatous germ cell tumors of the testes

yolk sac tumor, choriocarcinoma, teratoma, embryonal carcinoma


embryonal carcinoma: presentation, characteristics, histology, lab findings, prognosis

malignant, hemorrhagic mass with necrosis (painful), most commonly mixed with other tumor types
histology: glandular/papillary
lab findings: increased hCG and normal AFP (if pure, AFP is elevated when mixed)
prognosis: worse than seminoma


yolk sac tumor: characteristics, histology, lab findings

yellow, mucinous, aggressive malignancy of the testes, most common testicular tumors in boys <3 years old
histology: Schiller-Duval bodies resemble primitive glomeruli
lab findings: increased AFP is highly characteristic


testicular teratoma: pathogenesis, characteristics, lab findings

tumor composed of mature fetal tissue derived from two or three embryonic layers; malignant in males (as opposed to females), benign in children
lab findings: AFP or hCG may be increased


choriocarcinoma: characteristics, clinical presentation, lab findings

malignant, disordered syncytiotrophoblastic and cytotrophoblastic elements; hematogenous metastases to lungs and brain (may present with "hemorrhagic stroke" due to bleeding into metastasis
may produce gynecomastia, symptoms of hyperthyroidism (hCG is structurally similar to LH, FSH, TSH)
lab finding: increased hCG


what type of testicular tumors are mostly benign?

non-germ cell tumors


Sertoli cell tumor: important finding

etrogen productio by the tumor can result in gynecomastia and impotence


Leydig cell tumor: clinical presentation, histology, important finding

golden brown color
histology: Reinke crystals (eosinophilic cytoplasmic inclusions)
usually produce androgens --> gynecomastia in men, precocious puberty in boys


testicular lymphoma: characteristics, histology, prognosis

most common testicular cancer in older men; not a primary cancer, arises from metastatic lymphoma to testes
histology: usually of diffuse large B cell type
prognosis: aggressive


most common cause of scrotal enlargement in adult males

varicocele (dilated veins in paminiform plexus (vein that is in the scrotum draining the testicles) due to increased venous pressure)


compare and contrast epispadius and hypospadias

epispadias: abnormal opening of penile urethra on dorsal surface of penis due to faulty positioning of genital tubercle
hypospadius: abnormal opening of penile urethra on ventral surface of penis due to failure of urethral folds to fuse


Peyronie disease: pathogenesis, association, clinical presentation, treatment

abnormal curvature of penis due to fibrous plaques within tunica albuginea; associated with erectile dysfunction; painful
treatment: consider surgical repair once curvature stabilizes


risk factors for squamous cell carcinoma of the penis

HPV, lack of circumcision


Bowen disease: what is it

precursor for squamous cell carcinoma of the penis; in penile shaft, presents as leukoplakia


erythroplasia of Queyrat: what is it

precursor for squamous cell carcinoma of the penis; cancer of glans, presents as erythroplakia


Bowenoid papulosis: what is it

precursor for squamous cell carcinoma of the penis; carcinoma in situ with no predisposition for invasion, presents as reddish papules


varicocele: pathogenesis

dilated veins in pampiniform plexus (vein that is in the scrotum draining the testicles) due to increased venous pressure; most often on left side because of increased resistance to glow from left gonadal vein drainage into left renal vein; can cause infertility due to increase temeprature; "bag of worms" on palpation


diagnosis of varicocele

ultrasound with Doppler


if scrotal enlargement does not transilluminate, what are the differential diagnoses?

varicocele or testicular cancer


most common cause of scrotal enlargement



congenital hydrocele: pathogenesis

incomplete obliteration of processus vaginalis