Scrotum & Testes Pathologies Flashcards
What is hydrocele?
Accumulation of serous fluid between layers of tunica vaginalis
What is the most common cause of scrotal swelling in infants?
Congenital hydrocele
A newborn infant presents with scrotal swelling. An ultrasound shows light going through the tunica vaginalis of the scrotal sac and there is a connection between the processus vaginalis testis and the abdominal cavity. What is the likely diagnosis?
Congenital hydrocele
What can cause an acquired hydrocele?
Infection, tumor, or trauma
Long-standing hydrocele can lead to what conditions?
Testicular atrophy, compress the epididymis, or periorchitis
How is acquired hydrocele diagnosed?
Ultrasound or transluminating the fluid in the cavity
25 year old male patient presents to your office complaining of scrotal pain and swelling. An ultrasound is ordered and shows light going through the scrotal sac transluminating a fluid in the tunica vaginalis. Aspiration of the testicles shows a serous fluid around the testicles. The patient has a Hx of diabetes and frequent UTIs. What is the likely diagnosis and what is likely causing the patients pain?
Acquired hydrocele that led to pain caused by periorchitis
What is spermatocele?
Cyst formed from protrusions of widened efferent ducts of the rete testis or epididymis
A spermatocele will manifest as a hilar paratesticular nodule filled with _____________ fluid?
Milky
A cyst in a patient with spermatocele will have what histological characteristics?
Cuboidal epithelium that contains spermatozoa in various stages of degeneration
29 year old male patient presents to your office with testicular swelling. Ultrasound shows a cyst-like formation and a widened epididymis. The patient is not febrile. The cyst is aspirated and a milky fluid is visualized. The cyst is biopsied and shows cuboidal epithelium and spermatozoa in various stages of degeneration. What is the likely diagnosis?
Spermatocele
What is a varicocele?
Dilation of testicular veins appearing as a nodularity on the lateral side of the scrotum
Most varicoceles are (Symptomatic/Asymptomatic)?
Asymptomatic
Varicoceles can cause what complications?
Infertility and oligospermia
What is the palpable feel of a varicocele?
Bag of worms
35 year old male patient presents to your office for his daily appointment for LBP. In passing, he mentions that he is having difficulty difficulty getting his wife pregnant and they have been unsuccessful for over a year now. You decide to palpate the patients scrotum (why not?). Upon palpation you note a bag of worms feeling to the scrotal sac on the lateral side. What is the likely diagnosis?
Varicocele
What is dilated in a varicocele?
Pampiniform plexus
What is an inguinal hernia?
Intestinal protrusion into the scrotum through the inguinal canal
Patient presents to your office complaining of pain and swelling in his groin. The area around the inguinal canal is markedly swollen on the left side. The patient reports that the swelling has been present for awhile but he was afraid to go to the office until he noticed that his testicles were shrinking. What is he likely diagnosis based on this information?
Inguinal hernia
How can lymph accumulate in the scrotum?
Obstruction to lymphatic or venous drainage from pelvic abdominal tumors or surgical scars
Filariasis
Heart failure
Anasarca due to cirrhosis or nephrotic syndrome
What is anasarca? What primarily causes it?
Generalized edema primarily caused by renal failure
32 year old male patient presents to your office complaining of swelling in the scrotum. The patient has no history of heart pathology or extensive alcohol use. Notable in the patients history is a recent trip to his native Malaysia. A CBC shows eosinophilia and the presence of Brugia Malayi in the blood. A needle aspiration shows accumulation of lymphatic and serous fluid in the scrotum. What is the likely diagnosis?
Edema of the scrotum caused by filariasis
63 year old male patient presents to your office complaining of swelling in the scrotum. He suffered a heart attack two years prior and recently had to go on kidney dialysis. He has a long history of alcohol use as well. Upon inspection, the patient possesses a generalized swelling behind his eyes, in his hands, feet, and abdomen. What is the likely cause of swelling in his scrotum?
Edema of the scrotum caused by heart/renal/liver pathology
What is the most common carcinoma of the scrotum?
Squamous cell carcinoma
What occupation is scrotal carcinoma associated with?
Chimney sweeps
What is cryptorchidism?
Failure of the testes to descend and get arrested in the abdominal cavity, upper scrotum, or inguinal region
What are the most common location for an undescended testicle?
Upper scrotum or inguinal region
What can untreated cryptorchidism cause?
Infertility and increased risk of testicular cancer
All men with bilateral cryptorchidism testes have what complications?
Azoospermia and infertility
Newborn infant presents with a right testicle that has been arrested in the inguinal canal and has not fully descended. What is this condition called?
Cryptorchidism
What are main causes of pre-testicular male infertility?
Hypothalamus disorders
Pituitary diseases
What are main causes of testicular male infertility?
Orchitis
Cryptorchidism
Azoospermia
Radiation
(Iatrogenic
Trauma
Genetic chromosomal disorders)
What are main causes of post-testicular male infertility?
Infections
Vasectomy
Trauma
Prostate pathology
What are common etiologies of epididymitis in younger men?
Neisseria Gonorrheae or Chlamydia Trachomatis
Epididymitis is chararacterized by ____________________ inflammation?
Suppurative
What is the common etiologic agent of epididymitis in older men?
Escheria coli associated with UTIs
How will a patient with epididymitis present to your office?
Intra-scrotal pain and tenderness
Possible fever
Hx of UTI or STI
29 year old male patient presents to your office complaining of pain in his “balls”. The scrotum is tender to the touch. The patient is running a low fever. When asked about his sexual history the patient claims to having multiple partners in the past month. Needle aspiration of the epididymis shows high protein and high cell counts and a pus-like fluid. What is the likely diagnosis and causation of this patients complaint?
Epididymitis due to a Chlamydia or Gonorrhea infection
65 year old male patient presents to your office complaining of pain in his “balls”. The scrotum is tender to the touch. The patient is running a low fever. The patient does not report being active with multiple partners and has been happily married for 27 years. A needle aspiration of the epididymis shows a purulent exudate. The patient has a history of diabetes. What is the likely diagnosis and cause of this patients complaint?
Epididymitis due to Escheria coli from a UTI
What is orchitis?
Acute or chronic inflammation of the testis commonly secondary to a UTI and a gram-negative bacteria infection
What can cause orchitis?
Escheria coli or Klebsiella UTI
Mumps
Orchitis can develop in what pathology of parotid and salivary glands?
Mumps
What is torsion of the testes?
Congenital abnormality in which testes are inadequately affixed to the scrotum allowing rotation of the spermatic cord
15 year old male patient presents to your office in excruciating pain in his testicles that he says came on suddenly. Visual examination shows an elevated right testicle. You immediately refer the patient to the ER and surgery is performed. What is the likely diagnosis and what could be a complication of not treating this pathology quickly?
Torsion of the testes that will cause ischemia of the testicles if untreated
What is the most common tumor of the testes?
Seminoma
A seminoma is (Benign/Malignant)?
Malignant
What age group are seminomas most common?
25-40
Seminomas are highly curable if caught early (TRUE/FALSE)?
t
30 year old male patient presents to your office complaining of a swollen left testicle that he reports has been getting bigger for the past two months. Ultrasound shows a dark mass on the left testicle. Biopsy of the tissue shows cells that are poorly differentiated. What is the likely diagnosis. What is the treatment for this pathology?
Seminoma treated with radiotherapy/chemotherapy or possible orchiectomy
Patient presents with scrotal mass and elevated AFP. What pathology is suspected?
Non-seminoma testicular tumor
T/F testicular tumors may secrete HCG
T (non-seminomas)
