Chapter 14

Question 1

Most common type of testicular tumor

Answer 1

Germ cell tumors

Most common type of testicular tumor (>95% of cases)
B. Usually occur between 15- 40 years of age
C. Risk factors include cryptorchidism and Klinefelter syndrome.
D. Divided into seminoma and nonseminoma

Question 2

how is the most popular testicular tumor further divided?

Answer 2

Seminomas (55% of cases) are highly responsive to radiotherapy, metastasize late, and have an excellent prognosis.
2. Nonseminomas (45% of cases) show variable response to treatment and often metastasize early.

Question 3

what is a seminomas morphology

Answer 3

Seminoma is a malignant tumor comprised of large cells with clear cytoplasm and central nuclei (resemble spermatogonia, Fig. l4.4A); forms a homogeneous mass with no hemorrhage or necrosis (Fig. 14.4B)
1. Most common testicular tumor; resembles ovarian dysgerminoma

Question 4

what can a seminoma secrete?

Answer 4

beta HCG

Question 5

what is the morphology of embryonal carcinomas?

Answer 5

Embryonal carcinoma is a malignant tumor comprised of immature, primitive cells that may produce glands; forms a hemorrhagic mass with necrosis

1. Aggressive with early hematogenous spread
2. Chemotherapy may result in differentiation into another type of germ cell tumor
   (e. g., teratoma).
3. Increased AFP or may be present.

Question 6

what are seen with yolk sac tumors?

Answer 6

Yolk sac (endodermal sinus) tumor is a malignant tumor that resembles yolk sac elements .

l. Most common testicular tumor in children
2. Schiller-Duval bodies (glomerulus-like structures) are seen on histology (Fig.
14. 6).
3. AFP is characteristically elevated.

Question 7

what is a choriocarcinoma and what is a unique side effect?

Answer 7

Choriocarcinoma is a malignant tumor of syncytiotrophoblasts and cytotrophoblasts (placenta-like tissue, but villi are absent, Fig. 14.7).

1. Spreads early via blood
2. is characteristically elevated; may lead to hyperthyroidism or gynecomastia (a-subunit of hCG is similar to that of FSH, LH, and TSH)

Question 8

why are teratomas special?

Answer 8

Teratoma is a tumor composed of mature fetal tissue derived from two or three
embryonic layers.
1. Malignant in males (as opposed to females)
2. AFP or may be increased.

Question 9

where are reinke crystals seen

Answer 9

III. SEX CORD-STROMAL TUMORS

A. Tumors that resemble sex cord-stomal tissues of the testicle (Fig. 14.8); usually benign

B. Leydig cell tumor usually produces androgen, causing precocious puberty in children or gynecomastia in adults.

1. Characteristic Reinke crystals may be seen on histology.

C. Sertoli cell tumor is comprised of tubules and is usually clinically silent.

Question 10

Most common cause of a testicular mass in males > 60 years old?

Answer 10

IV. LYMPHOMA
A. B.
Most common cause of a testicular mass in males > 60 years old; often bilateral Usually of diffuse large B cell type