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House AMP > Testicular Tumors > Flashcards

Testicular Tumors Flashcards

1
Q

Testicular tumors

Are divided into two major categories

________ tumours

_____________ tumours

A

Germ cell

Sex cord stromal

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2
Q

Testicular tumors

Germ cell tumours
Divided into 2

List

A

Seminomatous
Non seminomatous tumours

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3
Q

Testicular tumors

Sex cord stromal tumours
Divided into 2

List

A

Leydig cell tumour

Sertoli cell tumour

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4
Q

Seminomatous tumours

________
________ seminoma
________ seminoma

A

Seminoma

Spermatocytic seminoma
Anaplastic seminoma

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5
Q

Non seminomatous tumours

– _________ carcinoma
_________ (_________) tumour _________
_________

A

Embryonal carcinoma
Yolk sac (endodermal sinus) tumour Choriocarcinoma
Teratoma

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6
Q

Teratoma
_________
________
Teratoma with ______________

A

Mature
Immature

malignant transformation

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7
Q

Germ cell tumours

Incidence shows remarkable _________ variation

The age distribution of testicular germ cell tumours is (usual or unusual?)

The incidence increases shortly after the ________and reaches a maximum in men in the ___________ and ________

Thereafter the age specific incidence rate decreases to a very low level in men in their __________.

A

geographical

unusual

after the onset of puberty

late twenties and thirties.

sixties.

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8
Q

The exact etiology of testicular germ cell tumours is not known

T/F

A

T

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9
Q

____________ are the most frequent of the testicular tumours

A

Germ cell tumors

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10
Q

predisposing factors to testicular germ cell tumor

However several factors are known

_____________ of the male genitalia. ______________ is the most important risk factor . The high incidence is due to its exposure to ______ temperature in the _______ or _______ region compared to the scrotum

A

Congenital malformations

Undescended testis

high ;abdomen

inguinal region

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11
Q

predisposing factors to testicular germ cell tumor

Prenatal risk factors ( _____ birth weight, _____ maternal age, neonatal ______)

Genetic/family predisposition: the cytogenetic abnormality observed is an additional fragment of chromosome _____ (_______________)

A

low; high

Jaundice

12; isochromosome p12

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12
Q

Congenital malformations of the male genitalia ( _____________,___________).

A

Cryptorchidism, hypospadias,

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13
Q

predisposing factors to testicular germ cell tumor

Klinefelter syndrome(XXY): is associated with ____ times greater risk than normal for the __________ germ cell tumour but they ________________________

Exposure in ____hood (low level of physical activity, high socioeconomic class)
Male _______

A

50; mediasternal

do not develop testicular tumours

adult; infertility

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14
Q

Seminoma

They almost never occur in the _____, and they peak in the ________.

An identical tumour arises in the ovary where it is called _________

A

infants ; thirties.

dysgerminoma

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15
Q

Seminoma

Classification

_________ or _________
_________
_________

A

Classical or typical
Spermatocytic
anaplastic

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16
Q

__________ is the commonest malignant tumour of the testis

A

Seminoma

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17
Q

_______ seminoma comprises about 95% of all seminomas

A

Classic seminoma

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18
Q

Classic seminoma

Morphology

The testis may enlarge up to _____ times its normal size but tends to maintain its _____________ since the tumour rarely invades the ________

The typical seminoma has a _____genous _________ lobulated cut surface usually devoid of _________ or _________

The entire testis may _______________

A

10 times ; contour

tunica; homogenous

grey white

haemorrhage or necrosis

be replaced

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19
Q

Morphology of classic Seminoma

Microscopically

Typical seminoma presents as ______ of fairly uniform (small or large?) ______ to _________ cells with distinct _________ , a _________ cytoplasm and a _________ central nucleus with ______________ nucleoli.

The cytoplasm contains variable amount of _________ that stains positively with _________ reaction

A

sheets ; large

round to polyhedral

cell membrane; clear

large ;one or two prominent

glycogen; PAS

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20
Q

Morphology of classic Seminoma

Microscopically

The cells are demarcated into _______ by _______ of _______ tissue.

The _______ septa is associated with _______ infiltrate

Mitoses are (frequent or infrequent?)

A

lobules ; delicate septa

fibrous tissue ; fibrous

lymphocytic ;infrequent

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21
Q

Spread of classic seminoma

Local spread : invasion of the _________, spread into _____ testis, invasion of the _________

Lymphatic spread: to ________ lymph nodes

Treatment: tumour is extremely _____sensitive

A

testicular parenchyma

rete; epididymis

abdominal; radio

22
Q

Spermatocytic sperminoma

It is both clinically and morphologically a distinctive tumour from classic seminoma.

It is a/an (common or uncommon?) testicular neoplasm derived from _________ cells (_________)
It occurs in (younger or older?) patients, generally in _________ decade of life.

A

uncommon ;mature germ cells

spermatogonia

older ; 6th

23
Q

Spermatocytic sperminoma

In contrast to classic seminoma, the prognosis of spermatocytic seminoma is ________ since it is a ____ growing tumour that ______________

A

excellent

slow

rarely metastasises.

24
Q

Spermatocytic sperminoma

Morphology

Grossly
Spermatocytic seminoma tends to be (smaller or larger?) than classic seminoma

Cut surface is ______, (soft or hard?) and ______

A

larger ; pale grey

soft ; friable

25
Q

Spermatocytic sperminoma

Morphology

Microscopically
The cells vary considerably in size from the _________ like to huge _________ or ___________________ cells

The cells have ______philic cytoplasm devoid of _________

The stroma lacks _________ as seen in classic seminoma

A

lymphocyte like

mononucleate ; multinucleate giant cells

eosinophilic ;glycogen

lymphocytes

26
Q

Anaplastic seminoma is more ______ and shows nuclear ______ with more frequent tumour ______ and many ______ figures

A

cellular ;pleomorphism

giant cells ; mitotic figures

27
Q

Anaplastic seminoma is associated with worse prognosis than classic seminoma

T/F

A

F

Its not associated with worse prognosis than classic seminoma

28
Q

Nonseminomatous germ cell tumor

•Embryonal carcinoma
Occur mostly in the ———- year age group
It is (more or less?) aggressive than seminomas
More than 60% have _________ at presentation
Can also be found within the _________

A

20 to 30

more ;metastases

retroperitoneum

29
Q

Nonseminomatous germ cell tumor

Embryonal carcinoma

Clinical Features
(Painless or Painful?) swelling of the testis
Occasionally testicular _____
_________
Symptoms related to _______

A

Painless ;pain

Gynecomastia; metastasis

30
Q

Embryonal carcinoma

Tumour is (poorly or well?) circumscribed, size is (small or large?) and cut surface shows a ________ appearance with areas of ________ and ________

Tumour commonly extends into the ________, ________ and the ________

Histologically the tumour cells grow in ________, ________ or ________ pattern.

A

poorly ; small

variegated ;haemorrhage and necrosis

tunica albuginea, epididymis and the spermatic cord

glandular, alveolar or tubular pattern.

31
Q

Yolk sac tumor

Also known as ___________ tumour is the most common testicular tumour in ___________ and ___________ up to ___ years of age.

In this early age group it has a very ___________ prognosis

A

endodermal sinus tumour

infants and children

3 years of age.

good prognosis

32
Q

Yolk sac tumor

Sites

_______
Also found in: _____, extragonadal (along ______ of the body

A

Testis; ovary

midline

33
Q

Yolk sac tumor

______ levels are elevated in 100% cases of yolk sac tumours

A

AFP

34
Q

Yolk sac tumor

The tumour cells form variety of patterns and may form distinctive perivascular structures resembling the yolk sac called ______________

A

Schiller-Duval bodies

35
Q

Choriocarcinoma

It is a (mildly or highly?) malignant tumour composed of elements consisting of ___________ and ___________.

It occurs in association with other germ cell tumours
Patients are generally in their ___________ decade

Morphologically the primary tumours are (small or large?), (soft or hard?) , _________ and _________.

A

highly ;syncytiotrophoblasts

cytotrophoblasts ; 2nd

small ; soft

haemorrhagic and necrotic.

36
Q

Teratoma

Is a group of tumours composed of tissues derived from ______________________ (_______ , _________ , __________ )

Pure teratomas constitute about ____% to ___% of germ cell tumours but teratomas mixed with other germ cell tumours form about ____% of germ cell tumours

A

more than one germ layer (ectoderm, mesoderm, and endoderm)

2% to 3%

45%

37
Q

Teratoma

Age: pure teratomas are common in _______ and _______ but rare in ______

A

infants and children

adults

38
Q

_______ is second most common germ cell tumor type in pediatrics, after ____________

A

Teratoma is second most common germ cell tumor type in pediatrics, after yolk sac tumor

39
Q

Morphology of teratoma

Grossly:

Most are (small or large?) ________ masses. Cut surface may be solid or cystic. Foci of ______ and ______ may be seen

A

large

greyish white

cartilage and bone

40
Q

Morphology of teratoma

Microscopically

Mature teratoma contains (poorly or well?) differentiated structures such as cartilage, bone, smooth muscle, intestinal and respiratory epithelium, mucus glands, cysts lined by squamous and transitional epithelium, neural tissue and fat.

They have _______ prognosis

A

well

excellent

41
Q

Immature teratoma

Immature is composed of _______ or _______ tissue along with some _______ element.

They have _______ prognosis

A

primitive ; embryonic

mature ; poor

42
Q

Teratoma with malignant transformation

: one or more of the (mature or immature?) elements undergo malignant transformation

A

mature

43
Q

Sex cord stromal tumors

They are (common or uncommon?)

They originate from the primitive _______ cells that form the specialised _______ of the _______ in both sexes

Since the cell of origin of primitive mesenchyme is _______, sertoli, interstitial leydig cell tumours, theca cell, granulosa cell and lutein cell tumours can occur in both sexes ie ovaries and testes.

They may secrete ________________________

A

uncommon

primitive mesenchymal cells

gonads in both sexes

identical

androgen and estrogen

44
Q

Tumor markers of testicular germ cell tumors

Seminoma- ___________ , ________,———-

Teratomas : ______________, ______________

Embryonal carcinoma : ______________, ______________

Yolk sac tumour: ______________

Choriocarcinoma: ______________

A

Placental alkaline phosphatase, CD117,HCG

AFP, hCG

CD30, CEA

AFP

beta-hCG

45
Q

Tumor markers of testicular germ cell tumors

__________ - Placental alkaline phosphatase, CD117

__________ : AFP, hCG

__________ : CD30, CEA

__________: AFP

__________: beta-hCG

A

Seminoma

Teratomas

Embryonal carcinoma

Yolk sac tumour

Choriocarcinoma

46
Q

Testicular tumor

Usually present as (painful or painless?) , testicular mass
Do not ___________

A

painless

transilluminate

47
Q

Seminoma may produce beta HCG

T/F

A

T

48
Q

Key distinctions of Embryonal carcinoma from seminoma:

EC is a Mass with _________ and _______

Is (Painful or Painless?)

A

hemorrhage and necrosis

Painful

49
Q

Embryonal carcinoma

May have _________ tissue
Secretes _____

A

Syncytiotrophoblast

β-hCG

50
Q

Testicular germ cell tumors

Clinically divided into two categories

Seminomas
Remain _________ for a long time
70% identified in stage ____
Metastasis to __________ first
__________ spread late

Non-seminomas
______ metastasis
Often ________

A

localized ; one

lymph nodes; Hematogenous

Early ; hematogenous

51
Q

Leydig cell tumor

Produce ________________

________

Sexual _______ (early puberty)

___________ mass (high lipid content)

___________ in cytoplasm of tumor cells

A

androgens and estrogens

Gynecomastia; precocity

Golden brown mass

Reinke crystals

52
Q

Sertoli cell tumor

Aka ___________

Usually do not ___________
• Most are (benign or malignant?)

A

Androblastoma

produce hormones

benign

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