Pathology of the Testes- Iczkowski Flashcards Preview

M2 Endo/Repro > Pathology of the Testes- Iczkowski > Flashcards

Flashcards in Pathology of the Testes- Iczkowski Deck (21):
1

 

What path do the testicles take to the scrotum during development?

 

What is cryptorchidism?

 

Testicles descend from the abdomen, through the inguinal ring, into the superior scrotum and finally settle into the scrotum.

 

A failure of the testicles to fully descend into the scrotum

2

 

What controls testicle descent?

 

What are some complications of cryptorchidism?

 

hCG controls descent

 

Mostly infertility, but increases the risk of germ cell tumors as well.  

3

 

What commonly causes epididymitis?

 

 

What sign is positive in epididymitis?

 

UTI if >35yo

STI if <35yo

Usually gonorrhea, chylamydia, TB, E coli, or Pseudomonas

 

Prehn's sign (relief when testes are elevated)

4

 

What is orchitis?

 

What causes it?

 

Inflammation of the testis

 

TB, mumps, HIV, syphilis, spread from epididymitis

*20% of adult mumps infection result in orchitis

5

 

What is testicular torsion?

 

What symptoms will the patient have?

 

Twisting of the spermatic cord to cut off the venous/arterial supply that can cause infarction

 

Sudden onset of pain, Negative Prehn's sign

6

 

What are the clinical findings in testicular cancer?

 

What are risk factors for testicular cancer?

 

Unilateral PAINLESS mass in the testicle

 

Cryptorchidism

Testicular Feminization (androgen insensitvity)

Klinefelter's syndrome- XXY

7

 

What are the three classes of testicular tumors? 

 

(This is the most general classification)

 

Germ Cell Tumors

Stromal Cell Tumors

Lymphoma

8

 

What are the two classes of testicular germ cell tumors?

 

What defines a tumor as one or the other?

 

Seminomas, Non-seminomas

 

A tumor is considered a seminoma if it's PURELY seminoma cells; mixed tumors may have elements of both types, but are treated like non-seminomas

 

 

9

 

What is ITGCN?

 

What abnormalities are seen?

 

Intratubular germ cell neoplasia; a precursor to germ-cell tumors

 

aneuploidy, Isochromosome 12p, atypical enlargemet in cells, absent spermatogenesis

10

 

What blood markers are seen in seminomas?

 

What is seen on histology in seminomas?

 

 

hCG might be elevated

 

Fibrous septa with lympocyte infiltrate, square nuclei

11

 

What are the four classes of non-seminoma testicular cancers?

 

How are these cells identified?

 

Choriocarcinoma

Embryonal carcinoma

Yolk Sac tumors

Teratomas

 

usually immunohistochemistry; remember, it is VERY COMMON for one tumor to contain multiple types of non-seminoma cells and even seminoma cells

12

 

What is the difference in treatment between seminomas and non-seminomas?

 

 

 

Tumors constrained in the testicle are treated by orchiectomy for both

 

If tumor has spread, both can be treated chemotherapy, but ONLY seminomas are radiosensitive

13

 

What blood markers are seen in embryonal carcinoma?

 

What is seen on histology?

 

hCG may be elevated

 

Gland-like structure formation, vesicular nuclei

14

 

What blood markers are seen in yolk sac tumors?

 

What is seen on histology?

 

Alpha-feto protein is elevated

 

Schiller-Duval bodies, microcyst formation

15

 

What blood markers are seen in teratomas?

 

What is seen on histology?

 

None

 

Multiple somatic tissues, including lung, muscle, cartilage, etc.  

16

 

 

What blood markers are seen in choriocarcinoma?

 

What is seen on histology?

 

 

Elevated hCG

 

syncytiotrophoblasts, intermediate trophoblasts, and mononuclear cytotrophoblasts 

 

17

 

What are the two testicular stromal cancers?

 

Leydig Cell Tumors

Sertoli Cell Tumors

18

 

How are Leydig cell tumors treated?

 

What is seen on histology?

 

Treated with orchiectomy, but retroperitoneal lymph node dissection is required if malignant

 

Clear cytoplasm, un-nested cells

19

 

What symptoms are seen in a Sertoli cell tumor?

 

What is seen on histology?

 

Estrogen production results in gynecomastia and impotence

 

linear "cords" of cells 

20

 

What is an adenomatoid tumor?

 

What is the prognosis?

 

A mesothelial tumor of the epididymis which may extend into the rete testis or spermatic cord.  

 

There are ALWAYS benign 

21

 

What pathologies can affect the testicular tunic?'

 

 

What pathology can affect the spermatic cord?

 

Hydrocele

Benign Papillary Mesothelioma

 

Vasitis Nodosa, usually a reaction to a vasectomy

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