Testis and Paratesticular Adnexa Flashcards
Germ cell role
dif to spermatids > spermatoza
morphology lymphoma
white to tan fleshy tumor
interstital growth patter, spares seminiferous tuules
difuse large cell types with B cell phenottype
most common tumor of epididymis
derived from
adenomatoid tumor (always benign)
mesothelial origin
associaited conditions orchitis
TB
mumps
HIV
syphilis
extension from epididymitis
most common teste tumor in age >60
lymphoma
Sertoli cells role
support germ cell devo to spermatozoa
produce inhibin> spermatogenesis
Aromatize T into estradiol > spermatogenesis
second most common germ cell tumor
embryonla carcinoma
Prehn’s sign
elevation relieves pain
indication of epididmytis
Epididmytis assocations
gonorrhea,
chlamdia,
TB
E coli,
psuedomonas
markers and morphology choriocarcinoma
serum B-hcG elevated
multinucelated synctiotrophoblastic cells or intermediate trophoblasts
markers embryonal carcnoma
Serum AFP normal
hCG up in 60% of cases
worse outcome in teratoma if
immature - contain immature neuroepithelium, blastema, carcinoid, or cellular stroma
typical findings in ITGCN
spermatogenesis abent in involved tubes
atypical with nuclear elargement and large nucleoli
aneuploid DNA
contains isochromosome 12p (like in seminoma)
non invasive precursor of germ cell tumors and testis (both seminoma and non-seminoma)
seen in cryptorchidism
Intratubular germ cell neoplasia (ITGCN)
papillary mesothelioma
papillary excrescenes in tunica vaginalis
hydrcele sac papillae lined by bland cells with large nuclei and nucleoli
morphology embryonal carcnoma
fleshy white grey tumor with prominent necrosis
large cells with vesticular nuclei, prominent nucleoili,
glandular structures
cryptorchidism
later association
testes fail to respond in hCG dependent process
germ cell tumors 4-10 times more likely
spermatic cord vasitis nodosa
usually post vasectomy - transected end of vas deferens
sperm containing ductules commicnating wiht central lumen of vas deferens, extend into stroma
resembles invasive adenocarcinoma, preence of sperm, chroniic ifnlammation, lack of atypia differentiate
treatment for non-seminomatous germ cell tumors
chemosensitive, not radiosensitive (unlike seminoma)
most common germ cell tumor in children/infants
morphology
yolk sac tumor (endodermal sinus tumor)
white to gray masses
myxoid and cystic change
Schiller Duval bodies - central vessel lined by loose connective tissue, in turn lined by malignat epithelium, all in a cystic space
main tumor marker for yolk sac tumor (endodermal sinus tumor)
elevated AFP
leydig cells produce ___ in response to ___
Testosterone in response to LH
most common metatases to testis
prostate cancer
risk factors for testicular cancer
Cryptoorchid testicle (intra-abdominal is greatest risk)
Testicular feminization
Klinefelters syndrome XXY
seminoma markers
histo
a-fetoprotein
B-human chorionic gonadtropin elevated
solid nests separated by fibrous spetae
lymphoid infiltrate
leydig cell tumor morphology
clear cytoplasm, no nesting
sheets or random arrangements
sertoli tumor morphology
closely packed cords
adenomatoid tumor morphology
circumstribed, grey-white
Choriocarcinoma prognosis
poorer, metatasizes to lungs and brain
sensitive to chemo
