021015 male pathology testis,adnexa Flashcards
tunica vaginalis
potential space that is an outpouching from peritoneum
crytorchidism
one or both testes fail to descend into scrotum (the process depends on hCG)
epididymitis-causes?
UTI, or STI
gorrhea, chlamydia, TB, E coli, Pseudomonas
Prehn’s sign
elevation of scrotum decreases pain –positive in epididymitis
orchitis
painful inflammatory condition of testis
caused by TB, mumps, HIV, syphilis, extension from epididymitis
torsion of testis
twisting of spermatic cord cuts off venous/arterial blood supply, causing ischemia of testis
sudden onset of testicular pain, negative Prehn’s sign
torsion of testis
risk factors for testicular cancer
cryptorchid testicle (most common) testicular feminization (female phenotype) Klinefelter's syndrome (XXY)
clinical findings for testicular cancer
unilateral, painless enlargement of testis
testicular tumors-germ cell type
seminoma
mixed
non-seminomatous
precursor for testicular germ cell tumors
ITGCN (non-invasive)
types of non-seminomatous germ cell testicular tumors
embryonal cancers
yolk sac tumor
choriocarcinoma
teratoma (matture or immature)
what pecent of pts with ITGCN develop invasive germ cell tumor within 7 yrs?
more than 70%
ITGCN
40% of cases are bilateral
spermatogenesis is absent
histology of ITGCN
nucleus and cyto are enlarged
irreguarly shaped nucleus
prominent nucleoli
markers for seminoma
alpha fetoprotein (AFP) is normal beta hCG can be elevated
key finding for seminoma on histology
lymphocyte infiltrate
how are non-seminomatous germ cell tumors diff from seminomas
non-seminomatous germ cell tumors of testis are NOT radiosensitive
embroynonal carcinoma markers
serum AFP normal
beta hCG elevated in 60%
embryonal carcinoma histology
large cells with vesicular (clumping and clearing) nuclei
GLANDULAR STRUCTURES
most common germ cell tumor in infants and children
yolk sac tumor (endodermal sinus tumor)
marker for yolk sac tumor
elevated serum alpha fetoprotein
Schiller-Duval bodies (central vessel rimmed by loose connec tis that in turn is lined by malignant epithelium, all within a cystic space)
yolk sac tumor
teratoma
MATURE form: somatic type tissues that can include intestine type glands, respiratory epithelium, cartilage, muscle, sq epithelium
IMMATURE: worse outcome
choriocarcinoma markers
serum beta hCG elevated
poorer prognosis
stain hCG positive
most common testis tumor over age 60
lymphoma
epididymis-most common tumor
adenomatoid tumor (ALWAYS BENIGN) probable mesothelial origin
most common cause of scrotal swelling
hydrocele (fluid in tunica vaginalis)
vasitis nodosa
sperm containing ductules extend into stroma
