Penile and Testicular tumors Flashcards by Kortney Powell

penile intraepithelial neoplasia is

a rare precancerous lesion

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PeIN is associated with what virus

Human papillomavirus (HPV)

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What kinds of clinical changes occur in PeIN

whitish discoloration
erythematous changes
ulceration

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what are the 4 variants of PeIN

warty
basaloid
warty/basaloid
Differentiated

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describe the wart variant of PeIN

Papillary growth with koilocytes

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describe the basaloid variant of PeIN

Monotonous small to intermediate sized cells

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describe the differentiated variant of PeIN

atypia at bottom layers

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describe the warty basaloid variant of PeIN

Papillary growth with basaloid cells in middle and lower third of epithelium

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PeIN is common in what group of the population

HIV+ men and with anal dysplasia

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what is the treatment for PeIN

laser or surgery

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What is the most common type of neoplasia

differentiated

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What is Bowen’s disease

a squamous cell carcinoma in situ

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what group is Bowen’s disease found in

elderly uncircumcised men

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what is the clinical presentation of Bowen’s disease

Erythematous

scaly patch or plaque on the shaft of the penis

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bowen’s has an over expression of what marker

p16

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what is the thickness level of the epethelial dysplasia in bowen’s

full thickness

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mitosis occurs in what layer of the epethelium in bowen’s disease

upper third

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SSC is the most common type of what

penile neoplasia

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what are the risk factors for SSC

phimosis
long foreskin
lichen sclerosis
injury
smoking
psoriasis tx/w UVB radiation

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what is the treatment of SSC

excision with or without lymph node dissection

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SSC is

mutlifocal

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what is the main pathogenesis in SSC

degradation and inactivation of p53, the tumor suppressor gene, and pRb, tumor suppressor gene retinoblastoma (E6/E7 subtypes)

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What type of lesions do you find in SSC

exophytic or ulcerated

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what are some pathological findings of SSC

large hyperchromatic irregular nuclei

prominent nucleoli

abnormal keratinization

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what is the treatment of SSC

excision with or without lymph node dissection

what is verrucous carcinoma

an extremely well-differentiated variant of SCC

verrucous carcinoma is common where

at the glans

verrucous carcinoma is positive or negative for HPV

negative

does verrucous carcinoma have p16 expression

what is the histology of verrucous carcinoma

well differentiated prominent intercellular bridges minimal atypia broad base and pushing borders

what is the treatment of verrucous carcinoma

surgery

can verrucous carcinoma recur

yes

Tunica vaginalis

extension of the peritoneal cavity

tunica albuginea

fiberous capsule extension into testis and seperates into lobules

tunica vasculosa

vascular layer

What staining technique is done to see the major cell types of the testis

H&E

spermatogenic cells

located in the seminerferous tubules, sermatogenesis

sortoli cells

located in semineferous tubules, supportive

leydig cells

in the interstitial tissue, endocrine function

germ cell tumors are the most common solid tumor in what age group

15-35

what is the most common malignant testicular tumor in men over 60

lymphoma

how to prostatic tumors present as clinically

painless mass

is lymphatic spread common in prostatic tumors

yes

what node does the prostatic tumor not spread to

inguinal unless previous surgery

hematogenous spread of tumors may be found where

liver lungs brain bones

Germ cell tumor

most common in men 25-29 years old

Germ cell tumor has what kind of histological type

mixed

where do germ cell tumors arise from

semineferous epithelium

if a germ cell tumor is bilateral it is called what

classical seminoma

the form of germ cell tumor in the elderly is called what

spermatocytic seminoma

in germ cell tumors are p53 mutations normal

yes

what are the risk factors for germ cell tumors

cryptorchidism family history testicular dysgenesis Li-Fraumeni syndrome

Types of germ cell tumors

1. Intratubular germ cell neoplasia (ITGCN) 2. Seminoma 3. Spermatocytic tumor 4. Chroriocarcinoma 6. Teratoma 7. Mixed giant cell tumor

Intratubular germ cell neoplasia (ITGCN) is also known as

germ cell neoplasia in situ (GCNIS)

Intratubular germ cell neoplasia (ITGCN) is common in tissues adjacent to

germ cell tumor less often yolk sac and teratoma

Intratubular germ cell neoplasia (ITGCN) is associated with

gonadal dysgenesis androgen insensitvity syndrome infertility cryptochidism

Intratubular germ cell neoplasia (ITGCN) can progress to

a germ cell tumor typically in 5 years

how is Intratubular germ cell neoplasia (ITGCN) usually found

incidentally in biopsy for fertility evaluation/treatment

what are the markers of Intratubular germ cell neoplasia (ITGCN)

PLAP

what is the management of Intratubular germ cell neoplasia (ITGCN)

watching waiting and evaluate serum levels

what serum levels should be watched in managing PLAP

hCG, AFP, HPL

Seminoma commonly increases with

serum PLAP

Seminoma commonly increases with what but is a less specific marker

LDH

Seminoma will have what elevated

cCG

what chromosome sequence may be over expressed in seminoma

12p KRAS CCND2 NANOG

Seminoma is a counterpart to

ovarian dysgerminoma

Seminoma is a common in infants

no - its rare in infants

Seminoma can present in

mediastinum pineal gland retropertoneumw

what is the pathological findings of seminoma

well demarcated gray-white lobulated and bulging cut surface clear cytoplasm prominent cell border large nuclei prominent nucleoli

what marker is seminoma negative for

cytokeratin

Spermatocytic tumor is not related to

classic seminoma because it does not arise from intratubular germ cell neoplasia

Spermatocytic tumor is negative for what

PLAP, hCG, AFP

Spermatocytic tumor has how many cell types

3: Small, medium, giant cells

choriocarcinoma

Most commonly a component of mixed tumor May present initially as metastasis to liver, lung, etc

choriocarcinoma happens in what two cell

Cytotrophoblast and syncytiotrophoblast

choriocarcinoma will be elevated in what marker

hCG

choriocarcinoma will be positve in what marker

hCG cytokeratin PLAP

Teratoma contains what

cellular component derived from 2 or 3 germ layers

Teratoma is the ___ most common after what in children

2nd most common after yolk sac tumor

Teratoma in adults is benign or malignant?

malignant

Teratoma is more commonly a component of what

mixed tumor

Teratoma pathologically may have what included

bone, tooth, hair

Mixed germ cell tumor is diagnosed how

listed as a mixed tumor and gives a lists component percentages

Mixed germ cell tumor has elevated levels of what and what does it suggest

AFP and it suggest a yolk sac tumor component

Whar are common markers for GCTumors

hCG AFP LDH