Pathology Of The Testis

Question 1

In older men fluid can accumulate where?

Answer 1

In tunica vaginalis, hydrocele cyst

Question 2

Most cases of acute epididymo-orchitis in what age?

Answer 2

20-39

Question 3

To differentiate from torsion and epididymo-orchiditis?

Answer 3

Ultrasound

Question 4

Collection of polymorphs is called?

Answer 4

Abscess

Question 5

What is torsion?

Answer 5

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

Question 6

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

Answer 6

6 hours

Question 7

What is orchidopexy?

Answer 7

Other testis attached to skin to avoid torsion of this

Question 8

Testicular cancer is higher in who?

Answer 8

Caucasian men

Question 9

Prostate cancer mor common in?

Answer 9

Black men

Question 10

Testicular accounts for less than?

Answer 10

1%

Question 11

Cryptochordism and undescended testis increases risk of cancer?

Answer 11

4-8 times

Question 12

Which genetic abnormalities are associated with testicular cancer?

Answer 12

Downs and klienfelters

Question 13

What can lead to cryptorchidism?

Answer 13

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

Question 14

Atrophic undescended testis appearance?

Answer 14

Scarred, fibrotic

Longer less round

Question 15

Classical seminoma affects?

Answer 15

Younger men

Question 16

Spermatocytic seminoma affects?

Answer 16

Older men

Question 17

What percentage of testicular cancers are due to germ cells?

Answer 17

90

Question 18

Classical seminomas accounts to what percent of seminomas?

Answer 18

95

And affect men 25-45

Tumour markers may be normal or raised

Question 19

Most common form of testicular cancer in children?

Answer 19

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

Question 20

What is wierd about choriocarcinoma?

Answer 20

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

Question 21

Difference between teratomas of ovary and testicular?

Answer 21

Ovaries are benign and testicular are always malignant

Question 22

A complex cyst is most likely?

Answer 22

Malignant

Question 23

Simple cysts are most likley?

Answer 23

Benign

Question 24

Yolk sac tumour and embryonal carcinoma give off which marker?

Answer 24

Alpha fetoprotein

Question 25

Choriocarcinoma and embryonal carcinoma give off which marker?

Answer 25

Beta hcg

Question 26

Which marker is given off by seminoma?

Answer 26

Lactate dehydrogenase

Question 27

Seminoma cells look?

Answer 27

Large with prominent lymphocytic infiltrate, vascular invasion

Question 28

Early seminoma looks?

Answer 28

Central white tumour surrounded by brown seminiferous tubules

Question 29

Advanced seminoma looks like?

Answer 29

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

Question 30

Which has best prognosis?

Answer 30

Seminoma because people present quite early on

Question 31

If chemotherapy before orchidectomy this is called?

Answer 31

Neoadjuvant

Question 32

In male teratoma there are no?

Answer 32

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

Question 33

What is acute epididymis-orchid is associated with?

Answer 33

Neisseria gonorrhoea Chlamydia trachomatis, In older men over 40 it is ecoli

Question 34

How to treat acute epididymis-orchid is?

Answer 34

Antibiotics, pain relief and scrotal elevation

Question 35

Hydrocele?

Answer 35

Collection of fluid around the testis surrounded by the tunica vaginalis

Question 36

Haemorrhaging infarction and polymorph infiltrate is seen when?

Answer 36

Testicular torsion

Question 37

Causes of testicular cancer?

Answer 37

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

Question 38

Germ cell tumours?

Answer 38

Seminomatous: Classical seminoma Spermatocytic seminoma ``` Non-seminamotus: Yolk sac Teratomas Choriocarcinoma Embryonal carcinoma ```

Question 39

Sex cord/ stromal tumours?

Answer 39

Leydig Sertoli Less than 5% of testicular tumours

Question 40

Rate of growth of seminoma?

Answer 40

Slow and spread slowly too

Question 41

Spermatocytic seminoma?

Answer 41

Rare tumour, affects older men age 65 Grow more slowly than classical seminoma and less likely to spread

Question 42

What type accounts for 40% of testicular tumours?

Answer 42

Embryonal carcinoma, tends to grow rapidly and spread quickly Pure form 3/4% of cases

Question 43

Difference in mature and immature teratomas?

Answer 43

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

Question 44

What is different about teratomas in males and females?

Answer 44

Females- mature cystic teratomas of ovary is benign Testicular teratomas are always malignant

Question 45

Signs of metastasis of testicular cancer?

Answer 45

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

Question 46

When would you use PET scan?

Answer 46

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