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DIT Reproductive > Repro 3 - Testicular Pathology > Flashcards

Repro 3 - Testicular Pathology Flashcards

1
Q

What is epididymitis and what is a test that can be done to see if it is this disease?

A

It is inflammation of the epididymis. Diagnosis can be done by elevating the testes, which will bring slight relief to the patient.

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2
Q

What is the treatment for epididymitis?

A

For patients younger than 35 (GC/Chlamydia): Ceftriaxone IM then doxycyline for 10 days. For patients older than 35 or history of anal intercourse (Enterobacteriaceae), fluoroquinolone for 10-14 days.

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3
Q

Why do we perform an ultrasound in testicular torsion?

A

Because we need to see blood flow; if we don’t see it, it is very grave.

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4
Q

What test can we do to differentiate b/w Testicular torsion vs epididymitis?

A

Elevation of the testes on someone suffering from testicular torsion will not relieve the pain slightly as it does in epididymitis.

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5
Q

What is testicular torsion?

A

Twisting of the spermatic cord causing ischemia. It is a high-riding testis w/ long axis oriented transversely. There is absence of cremasteric reflex.

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6
Q

What is the treatment for Testicular Torsion?

A

Manual untwist. Surgical detorsion w/ bilateral orchiopexy w/i 6hrs.

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7
Q

What is cryptorchidism?

A

Failure of testis to descend into scrotum. Usually unilateral and descent usually complete in 1st year of life.

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8
Q

What happens when the testes do not descend?

A

35x risk of malignant tumor in the undescended testicle (usually a germ cell tumor).

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9
Q

What is the most common testicular tumor?

A

Seminoma.

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10
Q

What is the age range when a seminoma would most likely appear?

A

From ages 15 to 35 y.o.

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11
Q

What is a seminoma?

A

Most common testicular tumor, appears at ages 15-35, is malignant and presents as painless homogenous testicular enlargement.

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12
Q

Why does Seminoma have a good prognosis?

A

It is radiosensitive and has a late metastasis (when found, they have most likely not metastasized).

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13
Q

What would be the female equivalent of a seminoma?

A

Ovarian dysgerminoma.

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14
Q

What do we see in histology of Seminoma?

A

Large cells and lobules w/ watery cytoplasm, giving it a “fried egg” appearance. This “fried-egg” appearance is also used in koilocytes in HPV and oligodendrogliomas.

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15
Q

What is a testicular Embyronal carcinoma?

A

A malignant, painful palpable mass in scrotum. They tend to be painful. AFP usually normal unless it is a mixed germ cell tumor. hCG may be elevated.

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16
Q

What do we see in the histology of embyronal carcinoma?

A

Appear more glandular and have a papillary morphology.

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17
Q

What is another name for Yolk sac tumor?

A

Endodermal sinus tumor.

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18
Q

What is the most common testicular cancer in children up to the age of three?

A

Yolk sac tumor AKA endodermal sinus.

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19
Q

What is a Yolk sac (endodermal sinus) tumor?

A

The most common testicular cancer in children up to the age 3, they are yellow and mucinous. Causes Schiller-Duval bodies, which resembles a primitive glomerular structure. Will have elevated AFP.

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20
Q

What is a choriocarcinoma?

A

A malignant cancer of disordered syncitotrophoblasts and cytotrophoblasts, hence elevating hCG. They metastasize thru the blood.

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21
Q

What is a teratoma?

A

A tumor of multiple tissue types. Mature teratomas in males may be malignant. Elevates nGC. AFP elevated in half the cases.

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22
Q

What is the most common of the non-germ cell tumors?

A

Leydig cell tumor.

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23
Q

What are Leydig cell tumors?

A

A most common of the non-germ cell tumors, they contain Reinke crystals which are lipofusion pigmented, rod-shaped crystal structures. It is androgen producing; can cause gynecomastia and precocious puberty. These tumors have a golden-brown color.

24
Q

What are Sertoli cell tumor?

A

A non-germ cell tumor, they secrete estrogen, causing gynecomastia. Most are benign. May be associated w/ Peutz-Jeghers syndrome And Carney syndrome.

25
Q

Which testicular tumor may be associated with Peutz-Jeghers syndrome and Carney syndrome?

A

Sertoli cel tumor.

26
Q

Which testicular cancer is the most common in older men?

A

Testicular lymphoma.

27
Q

What is testicular lymphoma?

A

Most common testicular cancer in older men, it is a secondary cancer (metastasis to testes).

28
Q

In what testicular cancer do we see Schiller-Duval bodies?

A

Yolk sac tumor.

29
Q

In what testicular cancer do we see increase in AFP?

A

Yolk sac tumor. Teratoma (50%).

30
Q

In what testicular cancer do we see increase in hCG?

A

Choriocarcinoma.

31
Q

In what testicular cancer do we see fried-egg appearance?

A

Seminoma.

32
Q

In what testicular cancer do we see normal AFP but increase in hCG?

A

Embryonal carcinoma.

33
Q

In what testicular cancer is the most common overall?

A

Seminoma.

34
Q

In what testicular cancer do we see syncytiotrophoblasts?

A

Choriocarcinoma.

35
Q

In what testicular cancer do we see as a painful tumor?

A

Embryonal carcinoma.

36
Q

Which testicular cancer has a very poor prognosis?

A

Embryonal carcinoma.

37
Q

In what testicular cancer do we see teeth and hair?

A

Teratoma.

38
Q

In what testicular cancer is the most common up to age 3?

A

Yolk sac tumor.

39
Q

In what testicular cancer is testosterone secreting?

A

Leydig cells.

40
Q

In what testicular cancer is estrogen secreting?

A

Sertoli cells.

41
Q

What is the Tunica vaginalis?

A

A serous covering of the testes.

42
Q

What would be tunica vaginalis lesions?

A

Hydrocele. Spermatocele. Varicocele.

43
Q

What is the cause of hydrocele?

A

A tunica vaginalis lesion, It is due to incomplete fusion of processus vaginalis. Can remain up to a year in newborns; it is benign.

44
Q

What is the cause of Spermatocele?

A

A tunica vaginalis lesion, due to dilated epididymal duct.

45
Q

What is the cause of varicocele?

A

A tunica vaginalis lesion, due to dilated veins in pampiniform plexus. Can cause infertility due to increased temperature. Causes a “bag of worms” feeling in PE.

46
Q

A 23 y.o patient presents with one testicle. For what is this patient at risk?

A

Testicular cancer (germ cell tumor).

47
Q

What testicular tumor Is composed of cytotrophoblasts and syncytiotrophoblasts?

A

Choriocarcinoma.

48
Q

What testicular tumor may present initially w/ gynecomastia?

A

Sertoli cell tumor. Leydig cell tumor.

49
Q

In what testicular cancer has elevated beta-hCG?

A

Choriocarcinoma. Embryonal carcinoma. Teratoma.

50
Q

In what testicular cancer has histologic appearance similar to koilocytes (cytoplasmic clearing)?

A

Seminoma.

51
Q

In what testicular cancer may have histologically alveolar or tubular appearance sometimes w/ papillary convolutions?

A

Embryonal carcinoma.

52
Q

In what testicular cancer is composed of multiple tissue types?

A

Teratoma.

53
Q

In what testicular cancer has histologic endodermal sinus structures (Schiller-Duval bodies)?

A

Yolk sac tumor.

54
Q

In what testicular cancer has cytoplasmic rod-shaped crystalloids of Reinke in 25% of cases?

A

Leydig cell tumor.

55
Q

In what testicular cancer has androgen-producing and associated w/ precocious puberty?

A

Leydig cell tumor.

DIT Reproductive (18 decks)

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