HIGH YIELD-TESTIS & EPIDIDYMIS

Question 1

what are the examples of testis and epididymis?

Answer 1

congenital anomalies
regressive changes
inflammatory disorders
vascular disturbances
lesions of the tunica vaginalis
neoplasms

Question 2

what is the testicle comprised of?

Answer 2

testis and epididymis

Question 3

what are the disorders of the testis?

Answer 3

congenital anomalies
regressive changes
inflammatory disorders
vascular disturbances 
lesions of tunica vaginalis
neoplasms

Question 4

what are the congenital anomalies fo the testicle?

major histology feature?
*clinical significance?

Answer 4

cryptochidism

leydig cells
*high prevalence of inguinal hernias and sterility, 10x increased incidence of testicular neoplasms

Question 5

what are the regressive changes?

Answer 5

atrophy

Question 6

the inflammatory disorders affecting the testis?

Answer 6

orchitis and epididymis
granulomatous (autoimmune) orchitis
inflammation specific
-gonorrhea, mumps orchitis, tuberculosis, syphilis

Question 7

what are the vascular disturbances of the testicles?

what are the causes?

Answer 7

torsion, fairly common

• trauma or other violent movement
• pre-exisitng structural lesions , like incompletely descended testicles***

Question 8

what are the lesions of the tunica vaginalis that affect the testicles?

*most common and has the most severe consequences?

Answer 8

within the tunica vaginalis

• hydrocele
• hematocele
• chylocele

below the tunica vaginalis

• spermatocele
• varicocele

*hematocele

Question 9

when you see Neoplasms of the testicles, what is the most associated consideration of its pathogenesis?

Answer 9

cryptorchidism

Question 10

what are the classification of the neoplasms?

which is the most common?

Answer 10

germ cell tumor
sex cord stromal tumors
lymphoma

germ cell tumor

Question 11

what are the examples of germ cell tumor?

Answer 11

seminoma
spermatohytic seminoma
embryomal carcinoma
yolk sac tumor
choriocarcinoma
teratoma
mixed tumors

Question 12

most common testicular caner in adult males (50% of all germ cell tumors)?

Answer 12

seminoma, extremely radiosensitive

Question 13

when do the following neoplasms of the testicle occur in the human cycle?

seminoma
embryomal
yolk sac
choriocarcinoma

Answer 13

adult

necrosis

children

worst, most aggressive tumor

Question 14

whats the histology of the choriocarcinoma, since its the worst?

Answer 14

histology
-cytotrophoblastic cells in sheets and cords

-multinucleated syncytiotrophoblastic cells containing B-HCG

Question 15

what are the germ cell layers?

Answer 15

mesoderm: muscle, cartilage, adipose tissue
endoderm: gut, bronchial epithelium
ectoderm: neural tissue, skin

Question 16

approx 50% of all germ cell tumors are this?

most common combination?

Answer 16

mixed tumors

teratoma
embryonal carcinoma
yolk sac tumor

Question 17

clinical features of germ cell tumors?

what stage is this?

tumor confined to testis

Answer 17

stage I

Question 18

clinical features of germ cell tumors?

what stage is this?

metastases to retroperitoneal lymph nodes

Answer 18

stage II

Question 19

clinical features of germ cell tumors?

what stage is this?

metastases outside retroperitoneal lymph nodes, metastasis above diaphragm

Answer 19

stage III

Question 20

clinical features of germ cell tumors:

retroperitoneal para aortic nodes

Answer 20

lymphatic metastases

Question 21

clinical features of germ cell tumors:

lungs>liver>brain>bone

Answer 21

hematogenous metastases

Question 22

tumors classified by biologic behavior?

Answer 22

seminoma, 70% present at stage I, >95% survival with radiotherapy

nonseminomatous germ cell tumors, 60% present at stage II or III, 80% survival with aggressive chemotherapy

choriocarcinoma, extensive metastases may be present even with small primary lesions

Question 23

lab assay ordered in assessing germ cell tumors?

tx?

Answer 23

alpha fetoprotein, HCG, lactate dehydrogenase

radiation
chemotherapy

Question 24

what are the examples of sex cord stromal tumors?

describe with it pathogenesis, clinical presentation, gross, histology?

Answer 24

leydig cell tumor (2% of all testicular tumors)

• androgens, estrogens, corticosteroids
• testicular mass, gynecomastia
• golden brown cut surface
• reinke crystals

Sertoli cell tumor (rare)

• androgens, estrogens
• testicular mass, rarely induces feminization
• homogenous grey-white to yellow mass
• trabeculae resembling immature seminiferous tubules

Question 25

most common testicular neoplasm?

Answer 25

lymphoma