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Reproduction Week 1 > Lecture 9: Testicular Pathology > Flashcards

Lecture 9: Testicular Pathology Flashcards

1
Q

What kind of environment does sperm mature in

A

High glycerophosphorylcholine

Carnitine

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2
Q

Where are the three sites of injury for infertility?

A
  1. Pretesticular
    • Hypothalamic Pituitary axis
    • Exogenous Hormones
  2. Testicular
    • Direct damage
    • Germ cell elements
  3. Posttesticular
    • Epididymis and beyond
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3
Q

What stimulates GnRH release?

A
  1. melatonin
  2. Norepinephrine
  3. Dopamine
  4. Histamine
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4
Q

What inhibits GnRH release?

A
  1. Testosterone
  2. Inhibin
  3. CRH
  4. Opiates, illness, stress
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5
Q

What injuries comprise pretesticular category?

A
  1. Androgen excess
    • adrenal tumor
    • testicular tumor
    • anabolic steroids
  2. Estrogen Excess
  3. thyroid/adrenal dysfunction
  4. Kallman’s Syndrome
  5. Hyperprolactinemia (associated with azoospermia)
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6
Q

What injuries comprise testicular?

A
  1. Genetic
  2. Cryptorchidism
  3. Vascular disease
  4. Torsion, trauma
  5. Infection
  6. Drugs and Toxins
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7
Q

What injuries comprise posttesticular?

A
  1. Drugs and toxins
  2. Systemic disease
  3. Alcohol
  4. diabetes
  5. Sickle cell disease
  6. CRF (chronic renal failure)
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8
Q

What is Kallman’s Syndrome?

A

Secondary to congenital defect in GnRH secretion by hypothalamus
Anosmia associated with failure of GnRH secreting neurons to be present…

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9
Q

What are the key characteristics of Congenital Adrenal Hyperplasia (CAH)?

A

Loss of 21-hydroxylase enzyme
Means that progesterone does not get converted to cortisol
Androgen excess, so inhibition of GnRH
Symptoms include
i. precocious puberty
ii. impairment of testicular maturation (paradoxically)

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10
Q

What is cryptorchidism?

A 
When testes do not totally descend
Accounts for 1% of infertility
Maldescended and normal gonads
Could be asymptomatic
MoA not known
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11
Q

What is a congenital POST testicular infertility cause?

A

Cystic fibrosis

- epididymal cysts
- absence of vas deferens
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12
Q

What is orchiopexy?

A

Pulling testes into scrotum

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13
Q

What are types of infection that can lead to testicular infertility?

A
  1. mumps
  2. e coli
  3. gonorrhea/syphilis
  4. tuberculosis
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14
Q

What is orchitis?

A

Inflammation of the testes

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15
Q

What are causes of ejaculatory dysfunction?

A

Diabetes
Spinal cord injury, MS
prostatectomy

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16
Q

What are the characteristics of Sertoli Cell only syndrome?

A
  1. Deficiency of FSH and LH
  2. Sertoli cell only syndrome with dysgenetic sertoli cells
    When there is only mature sertoli cells with no germ cells
17
Q

What environmental factors lead to sertoli cell only?

A
  1. irradiation
  2. cytotoxic therapy
  3. hormonal therapy for prostate cancer
  4. chemical/toxin exposure
18
Q

What are the two types of testicular tumors?

A
  1. germ cell

2. non germ cell cancers (not covered in lecture)

19
Q

What are the characteristics of germ cell tumors?

A
  1. seminoma
  2. spermatocytic seminoma
  3. embryonal carcinoma
  4. yolk sac tumor
  5. Choriocarcinoma
  6. Teratoma
20
Q

What does ITGCN stand for?

A

Intratubular germ cell neoplasia (ITGCN)

21
Q

What is a seminoma?

A

Most common pure GERM CELL tumor composed of relatively uniform cells with abundant clear cytoplasm, well defined cell borders, and nuclei with one or more prominent nucleoli
T-lymphocytes
Chromosome 12p

22
Q

Genetically, what are germ cell tumors associated with?

A

Chromosome 12p

Isochromosome (2 copies of same strand)

23
Q

What is a key histological characteristics of seminomas?

A

T lymphocytes are pericellular

98% cure rate for Stage I and Stage II seminoma

24
Q

What is an embryonal carcinoma?

A

Germ cell tumor composed of cells with epithelial appearance and marked cytologic ATYPIA
Only seen in adults….not seen in children
Necrosis and hemorrhage

25
Q

What is a yolk sac tumor?

A

Germ cell tumor characterized by a variety of growth patterns that recapitulate yolk sac, allantois, and extra-embryonic mesenchyme
Schiller-Duval Bodies

26
Q

What are the histological features of yolk sac tumor?

A 
Growth pattern is alveolar or tubular
Sometimes papillary convolutions
Have Serum ALPHA FETOPROTEIN (AFP)
Lack well formed glands
Large anaplastic
Indistinct cell borders
27
Q

What are schiller-duval bodies?

A

Structures resembling endodermal sinus

Key characteristic of yolk sac tumor

28
Q

What is the definition of the choriocarcinoma?

A 
Germ cell tumor composed of
	i. mononucleated cytotrophoblast
	ii. multinucleated syncytiotrophoblast
Has a shitload of hCG
Has syncytiotrophoblastic giants cells
Bad prognosis
29
Q

What is the definition of teratoma?

A

Tumors with more than one somatic tissue of different germinal layers
Ectoderm, mesoderm or endoderm

30
Q

What are the two types of teratoma?

A
  1. Mature teratoma

2. Immature teratoma

Reproduction Week 1 (13 decks)

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