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203 > Pathology Of The Testis > Flashcards

Pathology Of The Testis Flashcards

1
Q

In older men fluid can accumulate where?

A

In tunica vaginalis, hydrocele cyst

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2
Q

Most cases of acute epididymo-orchitis in what age?

A

20-39

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3
Q

To differentiate from torsion and epididymo-orchiditis?

A

Ultrasound

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4
Q

Collection of polymorphs is called?

A

Abscess

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5
Q

What is torsion?

A

Twisting of spermatic cord which cuts off the venous drainage of the testis,if untreated can lead to infarction

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6
Q

In how many hours will untwisting will the testis remain viable?

A

6 hours

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7
Q

What is orchidopexy?

A

Other testis attached to skin to avoid torsion of this

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8
Q

Testicular cancer is higher in who?

A

Caucasian men

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9
Q

Prostate cancer mor common in?

A

Black men

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10
Q

Testicular accounts for less than?

A

1%

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11
Q

Cryptochordism and undescended testis increases risk of cancer?

A

4-8 times

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12
Q

Which genetic abnormalities are associated with testicular cancer?

A

Downs and klienfelters

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13
Q

What can lead to cryptorchidism?

A

Exposure to oestrogens in uterus ( women were given it to maintain pregnancy)

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14
Q

Atrophic undescended testis appearance?

A

Scarred, fibrotic

Longer less round

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15
Q

Classical seminoma affects?

A

Younger men

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16
Q

Spermatocytic seminoma affects?

A

Older men

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17
Q

What percentage of testicular cancers are due to germ cells?

A

90

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18
Q

Classical seminomas accounts to what percent of seminomas?

A

95

And affect men 25-45

Tumour markers may be normal or raised

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19
Q

Most common form of testicular cancer in children?

A

Yolk sac carcinoma, rare in adults hence better prognosis in children too

20
Q

What is wierd about choriocarcinoma?

A

Rare, fast growing in adults, spreads to lungs bones and brain

Usually present in mixed germ cell tumours it’s associated haemorrhage

Can happen in women, she becomes pregnanct, embryo dies and she develops choriocarcinoma, raised bhcg

21
Q

Difference between teratomas of ovary and testicular?

A

Ovaries are benign and testicular are always malignant

22
Q

A complex cyst is most likely?

A

Malignant

23
Q

Simple cysts are most likley?

A

Benign

24
Q

Yolk sac tumour and embryonal carcinoma give off which marker?

A

Alpha fetoprotein

25
Q

Choriocarcinoma and embryonal carcinoma give off which marker?

A

Beta hcg

26
Q

Which marker is given off by seminoma?

A

Lactate dehydrogenase

27
Q

Seminoma cells look?

A

Large with prominent lymphocytic infiltrate, vascular invasion

28
Q

Early seminoma looks?

A

Central white tumour surrounded by brown seminiferous tubules

29
Q

Advanced seminoma looks like?

A

Potato, no haemorrhage or necrosis, only if choriocarcinoma present too

30
Q

Which has best prognosis?

A

Seminoma because people present quite early on

31
Q

If chemotherapy before orchidectomy this is called?

A

Neoadjuvant

32
Q

In male teratoma there are no?

A

Hairs or sebaceous glands, and immature cartilage present (very blue)

33
Q

What is acute epididymis-orchid is associated with?

A

Neisseria gonorrhoea
Chlamydia trachomatis,

In older men over 40 it is ecoli

34
Q

How to treat acute epididymis-orchid is?

A

Antibiotics, pain relief and scrotal elevation

35
Q

Hydrocele?

A

Collection of fluid around the testis surrounded by the tunica vaginalis

36
Q

Haemorrhaging infarction and polymorph infiltrate is seen when?

A

Testicular torsion

37
Q

Causes of testicular cancer?

A 
Cryptorchidism and undescended testis 
Previous testicular cancer
Kelinfelters and downs 
FH 
Men with infertility problems
Exposure to oestrogens
38
Q

Germ cell tumours?

A

Seminomatous:
Classical seminoma
Spermatocytic seminoma

Non-seminamotus:
Yolk sac
Teratomas
Choriocarcinoma 
Embryonal carcinoma
39
Q

Sex cord/ stromal tumours?

A

Leydig
Sertoli
Less than 5% of testicular tumours

40
Q

Rate of growth of seminoma?

A

Slow and spread slowly too

41
Q

Spermatocytic seminoma?

A

Rare tumour, affects older men age 65

Grow more slowly than classical seminoma and less likely to spread

42
Q

What type accounts for 40% of testicular tumours?

A

Embryonal carcinoma, tends to grow rapidly and spread quickly

Pure form 3/4% of cases

43
Q

Difference in mature and immature teratomas?

A

Mature formed by cells similar to adult tissue, rarely spread, cured with surgery but may come back

Immature resemble those of early embryo, invade tissues

44
Q

What is different about teratomas in males and females?

A

Females- mature cystic teratomas of ovary is benign

Testicular teratomas are always malignant

45
Q

Signs of metastasis of testicular cancer?

A

Back pain due to enlarged para optic l nodes

Supraclavicular lymphadenopathy

Cough chest pain heamoptysis and sib due to metastasis t lungs

Gynaecomastia- due to beta hcg secretion

46
Q

When would you use PET scan?

A

To scan for recurrent disease after treatment lesion appear hot when there is a viable cancer

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