HIGH YIELD-TESTIS & EPIDIDYMIS Flashcards
what are the examples of testis and epididymis?
congenital anomalies regressive changes inflammatory disorders vascular disturbances lesions of the tunica vaginalis neoplasms
what is the testicle comprised of?
testis and epididymis
what are the disorders of the testis?
congenital anomalies regressive changes inflammatory disorders vascular disturbances lesions of tunica vaginalis neoplasms
what are the congenital anomalies fo the testicle?
major histology feature?
*clinical significance?
cryptochidism
leydig cells
*high prevalence of inguinal hernias and sterility, 10x increased incidence of testicular neoplasms
what are the regressive changes?
atrophy
the inflammatory disorders affecting the testis?
orchitis and epididymis
granulomatous (autoimmune) orchitis
inflammation specific
-gonorrhea, mumps orchitis, tuberculosis, syphilis
what are the vascular disturbances of the testicles?
what are the causes?
torsion, fairly common
- trauma or other violent movement
- pre-exisitng structural lesions , like incompletely descended testicles***
what are the lesions of the tunica vaginalis that affect the testicles?
*most common and has the most severe consequences?
within the tunica vaginalis
- hydrocele
- hematocele
- chylocele
below the tunica vaginalis
- spermatocele
- varicocele
*hematocele
when you see Neoplasms of the testicles, what is the most associated consideration of its pathogenesis?
cryptorchidism
what are the classification of the neoplasms?
which is the most common?
germ cell tumor
sex cord stromal tumors
lymphoma
germ cell tumor
what are the examples of germ cell tumor?
seminoma spermatohytic seminoma embryomal carcinoma yolk sac tumor choriocarcinoma teratoma mixed tumors
most common testicular caner in adult males (50% of all germ cell tumors)?
seminoma, extremely radiosensitive
when do the following neoplasms of the testicle occur in the human cycle?
seminoma
embryomal
yolk sac
choriocarcinoma
adult
necrosis
children
worst, most aggressive tumor
whats the histology of the choriocarcinoma, since its the worst?
histology
-cytotrophoblastic cells in sheets and cords
-multinucleated syncytiotrophoblastic cells containing B-HCG
what are the germ cell layers?
mesoderm: muscle, cartilage, adipose tissue
endoderm: gut, bronchial epithelium
ectoderm: neural tissue, skin
approx 50% of all germ cell tumors are this?
most common combination?
mixed tumors
teratoma
embryonal carcinoma
yolk sac tumor
clinical features of germ cell tumors?
what stage is this?
tumor confined to testis
stage I
clinical features of germ cell tumors?
what stage is this?
metastases to retroperitoneal lymph nodes
stage II
clinical features of germ cell tumors?
what stage is this?
metastases outside retroperitoneal lymph nodes, metastasis above diaphragm
stage III
clinical features of germ cell tumors:
retroperitoneal para aortic nodes
lymphatic metastases
clinical features of germ cell tumors:
lungs>liver>brain>bone
hematogenous metastases
tumors classified by biologic behavior?
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
lab assay ordered in assessing germ cell tumors?
tx?
alpha fetoprotein, HCG, lactate dehydrogenase
radiation
chemotherapy
what are the examples of sex cord stromal tumors?
describe with it pathogenesis, clinical presentation, gross, histology?
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
most common testicular neoplasm?
lymphoma
