testicular tumors

Question 1

when are tumors of the testis most likely to be diagnosed>

Answer 1

between the ages of 25-45

Question 2

what origin are the tumors most likely

Answer 2

germ cell

Question 3

are they typically benign or malignant

Answer 3

malignant

Question 4

are they curable and how?

Answer 4

surgery and chemo

Question 5

what is the most important marker cytogenetically

Answer 5

isochromosome p12

Question 6

where do they metastasize

Answer 6

periaortic abdominal lymph nodes

Question 7

what percentage release markers into the blood?

Answer 7

65%

Question 8

what is intratubular germ cell neoplasia

Answer 8

this is a testicular carcinoma in situ, a pervasive form of germ cell tumor.

Question 9

characteristics of ITGCN

Answer 9

patchy testicular tubule involvement. tubules affected have thick basement membranes and no sperm. neoplastic germ cells attached to the basal lamina. cells are large, have finely dispersed chromatin and display prominent nucleoli. there is typically abundant clear cytoplasm full of glycogen. nuclear DNA is triploid.

Question 10

how does ITGCN stain?

Answer 10

PLAP, OCT3/4

Question 11

seminomas

Answer 11

never found in prepubertal children, they are the most common tumor. solid, rubbery-firm, bosselated mass. sharply demarcated from the surrounding tissue. it appears lobulated and homogeneously tan or grayish yellow. necrosis or hemorrhage can be found.

Question 12

histological appearance of seminoma

Answer 12

uniform, polygonal cells, centrally located vesicular nuclei, ample cytoplasm with clear or eosinophilic. glycogen and lipid. the tumor is arranged in nests or sheets with fibrous septa containing lymphocytic infiltrate and occasionally granuloma with giant cells.

Question 13

how do seminomas stain?

Answer 13

PLAP and CD117 (c-kit).

Question 14

what are the different types of seminoma?

Answer 14

the most important is syncytiotrophoblastic seminoma. the other is anaplastic. syncytiotrophoblast are characterized by giant cells.

Question 15

how to determine the synctiotrophoblastic seminoma>

Answer 15

it has syncytiotrophoblastic giant cells and stains for beta-hCG

Question 16

what are the different types of nonseminomatous tumors?

Answer 16

1. ) pure embryonal
2. ) teratocarcinomas (mixed germ cell tumors)
3. ) pure coriocarinoma
4. ) pure yolk sac carcinoma
5. ) growing benign teratoma.

Question 17

pure embryonal carcinomas

Answer 17

similar to preimplantation cells, little cytoplasm, hyper chromatic large nuclei, arranged in broad solid sheets/cords/glands/tubules/acini. mets to abdominal lymph nodes, lung. these are the stem cells for teratocarcinomas

Question 18

histological markers for pure embryonal tumors

Answer 18

PLAP, OCT3/4. express cytokeratins and CD30. NOT c-kit (CD117)

Question 19

choriocarcinomas

Answer 19

composed exclusively of malignant chorionic epithelial cells.

Question 20

what are markers for non-seminomatous

Answer 20

AFP and b-hCG

Question 21

what tumor will produce AFP?

Answer 21

yolk sac tumor

Question 22

what cells release b-hCG?

Answer 22

syncytiotrophoblasts

Question 23

what tumor is found almost exclusively <4 yrs

Answer 23

yolk sac tumor

Question 24

what tumor type is found between 4 and 12

Answer 24

benign teratoma

Question 25

yolk sac tumor characterisitics

Answer 25

cells arranged into structures that look similar to fetal yolk sac. SCHILLER-DUVAL BODIES or glumeruloid like structures are characteristic. malignant.

Question 26

choriocarcinoma characteristics

Answer 26

multinucleated syncytiotrophoblastic giant cells. there are cyncytiotrophoblastic cells that are mononuclear; the invasive growth is associated with hemorrhage

Question 27

leydig tumors

Answer 27

yellow-brown, fibrous trabeculae giving a lobular appearance. uniform cells with round nuclei and well-developed eosinophilic or vacuolated cytoplasm. REINKE crystals -rectangular, eosinophilic inclusions. benign.

Question 28

what do leydig tumors do?

Answer 28

typically cause precocious puberty or feminization and gynecomastia.

Question 29

sertolli cell tumors

Answer 29

sex-cord stromal tumor. well-circumscribed, yellow-gray nodules. columnar cells arranged in tubules or cords in a fibrous trabecular framework.