SM_227b: Pathology of the Testis Flashcards
Describe testicular cell components
Testicular cell components
- Developing germ cells
- Sex cord stromal cells: Leydig cells, Sertoli cells
- Connective tissues
- Blood and lymphocytes
Describe stepwise maturation of germ cells in testis
Stepwise maturation of germ cells in testis
- Spermatogonia
- Spermatocytes
- Spermatids
- Spermatozoa
These are ____
These are Leydig cells
These are ___
These are Sertoli cells
This is ___
This is crystal of Reinke
This is stained for ___
This is stained for inhibin
Epididymitis and orchitis are usually ___
Epididymitis and orchitis are usually acute bacterial
- Younger men: often sexually transmitted (Chlamydia trachomatis, Neisseria gonorrhoeae)
- Older men: often related to UTI (E. coli, other Gram negative rods, enterococci, staphylococcus spp.)
- Can also be viral or other
This testicular caseating granuloma is caused by ____
This testicular caseating granuloma is caused by TB
This is ___
This is non-specific granulomatous orchitis
Cryptorchidism is ____
Cryptorchidism is undescended testis
- Normally testes descend to scrotum during fetal development (7-8th month)
- Failure of one or both testes to move from abdomen into scrotum after birth
- Increased risk of developing testicular cancer
Two phases of normal testicular descent are ____ and ____
Two phases of normal testicular descent are abdominopelvic phase and inguinal-scrotal phase
This is ____
This is cryptorchidism
Reactive and reparative conditions of testes are ___, ___, and ___
Reactive and reparative conditions of testes are atrophy, infertility, and others
Atrophy is aging or therapy-related
This is ___ occurring due to ___
This is testicular atrophy occurring due to anti-androgen treatment
Germ cells with maturation arrest: ____ -> ____ -> ____
Germ cells with maturation arrest: spermatogonia -> spermatocytes -> no spermatids and no spermatozoa
This is a ___
This is a Sertoli cell only pattern
This is a ___
This is a sperm granuloma
Hydrocele is when ____ leading to ____
Hydrocele is when testis is suspended in the sac filled with fluid leading to an atrophic change of the testis
Vascular abnormalities of the testis are ____, ____, ____, and ____
Vascular abnormalities of the testis are varicocele, torsion, vasculitis, and atherosclerosis
Varicocele is ___
Varicocele is abnormal dilation of the veins draining the testes
- Obstructs outflow -> oligo- or azospermia
Testicular torsion may lead to ____
Testicular torsion may lead to hemorrhagic necrosis
Testicular neoplasms are classified as ____ or ____
Testicular neoplasms are classified as germ cell tumors or other tumors
Germ cell neoplasia in situ is ____
Germ cell neoplasia in situ is neoplastic germ cells growing within tubules
- Diffuse lesion, no mass, noninvasive
- Present in almost all invasive GCT cases
- C-kit, Oct-4, and PLAP positive
C-kit, Oct-4, and PLAP positive is ___
C-kit, Oct-4, and PLAP positive is germ cell neoplasia in situ
____ is composed of large primitive tumor cells in diffuse or sheet like patterns and with lymphocytes or granulomas
Seminoma is composed of large primitive tumor cells in diffuse or sheet like patterns and with lymphocytes or granulomas
- PLAP, c-kit, OCT-4
- Occassionally syncytiotrophoblasts present: mildly increased hCG
Seminoma markers are ____, ____, and ____
Seminoma markers are PLAP, c-kit, OCT-4
- PLAP: placental alkaline phosphatase
____ occurs at older age, is not related to intratubular germ cell neoplasia, has small / medium / large cells, and good prognosis
Spermatocytic seminoma occurs at older age, is not related to intratubular germ cell neoplasia, has small / medium / large cells, and good prognosis
Nonseminomatous germ cell tumors are ____, ____, ____, and ____
Nonseminomatous germ cell tumors are embryonal carcinoma, yolk sac (endodermal sinus) tumor, choriocarcinoma, and mature / immature teratoma
Describe nonseminomatous mixed GCT
Nonseminomatous mixed GCT
- Embryonal carcinoma present in 87% of mixed GCY
- Teratoma present in 50% of mixed GCT
- YST present in 44% of mixed GCT
- Choriocarcinoma present in 15% of mixed GCT
Describe embryonal carcinoma
Embryonal carcinoma
- Majority of cases seen in the mixed GCT
- > 10% as pure form
- Tumor often shows hemorrhage and necrosis
- Primitive and pleomorphic tumor cells
- Solid, glandular, or papillary pattern
Describe yolk sac tumor
Yolk sac tumor
- Most common GCT in children as pure form
- Grossly myxoid or gelatinous cut surface
- Many histological patterns
- Most common pattern: microcystic
- AFP, glypican 3 positive
Schiller-Duval body is found in ___
Schiller-Duval body is found in yolk sac tumor
Choriocarcinoma consists of ____ and ____
Choriocarcinoma consists of syncytiotrophoblasts and cytotrophoblasts
This is an ____
This is an immature teratoma
This is a ____
This is a mature teratoma
____ which causes ____ chromosome has been shown in most testicular GCTs
l(12p) which causes duplication of the short arm of chromosome 12 chromosome has been shown in most testicular GCTs
Sex cord stromal tumors are ____, ____, and ____
Sex cord stromal tumors are Leydig cell tumor, Sertoli cell tumor, and other types
- Mostly benign, small percentage malignant
- Germ cell markers negative
- Inhibin positive
This is a ____
This is a Leydig cell tumor
This is a ____
This is a Sertoli cell tumor
Describe testicular lymphoma
Testicular lymphoma
- Typically older patients (6-80)
- No discrete mass
- Infiltrating lymphoma between tubules
- Mast cases are large B cell lymphoma
This is ____
This is metastatic prostatic adenocarcinoma to the testis
