Testes

Question 1

Seminoma Histologic Characteristics

Answer 1

1- fibrous stroma w/ small lymphocytes2- distinctive cell bordersAlso generally:polygonal in shapeclear cytoplasmlarge nuclei w/ prominent nucleolivariable mitotic activity

Question 2

Choriocarcinoma component in Seminoma Histologic Characteristics

Answer 2

1- cytotrophoblasts2- syncytial trophoblasts3- hemorrhage**worse prognosis

Question 3

Anaplastic Seminoma

Answer 3

marked nuclear pleomorphismincreased mitotic activitiesworse prognosis

Question 4

Spermatcytic seminoma

Answer 4

raredistictive in appearanceclinically indolent course & older population

Question 5

Embryonal carcinoma

Answer 5

WORSE PROGNOSISDifferent treatmentmore pleomorphicprimitivemore brisk mitotic activityno distinctive cell bordersnuclear overlapping

Question 6

Seminoma ImmunophenotypeKeratinPLAPAFPCD117CD30

Answer 6

Keratin (-)PLAP (+)AFP (-)CD117 (+)CD30 (-)

Question 7

Embryonal ImmunophenotypeKeratinPLAPAFPCD117CD30

Answer 7

Keratin (+)PLAP (-)AFP (+)CD117 (-)CD30 (+)

Question 8

Yolk Sac tumor Microscopic Characteristics

Answer 8

“polyvesicular or microcystic”“Glomeruloid” bodies - Schiller-Duval bodies”Embryoid” bodies mimic bilaminar embryonic plate”hyaline globules” - extra or intracytoplasmic & PAS positive

Question 9

Yolk Sac Tumors General Characteristics

Answer 9

Kids

Question 10

Choriocarcinoma General Characteristics

Answer 10

20-30 yo, mixed forms, aggressive, lung spread, poor prognosisVery high b-hCGGynecomastia possibleContains trophoblastic tumors

Question 11

Three cancers that can cause positive pregnancy test in male (elevated hCG)

Answer 11

ChoriocarcinomaSeminomaEmbryonal

Question 12

Teratoma

Answer 12

Males of all agesCells from all 3 germ layers; Commonly occurs mixed w/ embryonic carcinoma AGE OF THE PATIENT is most important; will always be malignant after puberty regardless of maturity; in childhood always benign, especially if mature; immature in kids are rare, also usually benign AFP and hCG increased in 50%

Question 13

Lymphatic drainage…testesscrotum

Answer 13

Testes - paraaortic LNscrotum - superficial inguinal

Question 14

Stromal/Sex Cord Tumors

Answer 14

Leydig/Sertoli hyperplasia in cryptorchidismMost Leydig tumors are in descendedEndocrine Rarely malignantSertoli only is rare, but 25% malignantMixed S/L and granulosa tumors reported