Testis and Paratesticular Adnexa

Question 1

Germ cell role

Answer 1

dif to spermatids > spermatoza

Question 2

morphology lymphoma

Answer 2

white to tan fleshy tumor

interstital growth patter, spares seminiferous tuules

difuse large cell types with B cell phenottype

Question 2

most common tumor of epididymis

derived from

Answer 2

adenomatoid tumor (always benign)

mesothelial origin

Question 3

associaited conditions orchitis

Answer 3

TB

mumps

HIV

syphilis

extension from epididymitis

Question 4

most common teste tumor in age >60

Answer 4

lymphoma

Question 5

Sertoli cells role

Answer 5

support germ cell devo to spermatozoa

produce inhibin> spermatogenesis

Aromatize T into estradiol > spermatogenesis

Question 5

second most common germ cell tumor

Answer 5

embryonla carcinoma

Question 7

Prehn’s sign

Answer 7

elevation relieves pain

indication of epididmytis

Question 8

Epididmytis assocations

Answer 8

gonorrhea,

chlamdia,

TB

E coli,

psuedomonas

Question 8

markers and morphology choriocarcinoma

Answer 8

serum B-hcG elevated

multinucelated synctiotrophoblastic cells or intermediate trophoblasts

Question 9

markers embryonal carcnoma

Answer 9

Serum AFP normal

hCG up in 60% of cases

Question 10

worse outcome in teratoma if

Answer 10

immature - contain immature neuroepithelium, blastema, carcinoid, or cellular stroma

Question 11

typical findings in ITGCN

Answer 11

spermatogenesis abent in involved tubes

atypical with nuclear elargement and large nucleoli

aneuploid DNA

contains isochromosome 12p (like in seminoma)

Question 12

non invasive precursor of germ cell tumors and testis (both seminoma and non-seminoma)

seen in cryptorchidism

Answer 12

Intratubular germ cell neoplasia (ITGCN)

Question 12

papillary mesothelioma

Answer 12

papillary excrescenes in tunica vaginalis

hydrcele sac papillae lined by bland cells with large nuclei and nucleoli

Question 13

morphology embryonal carcnoma

Answer 13

fleshy white grey tumor with prominent necrosis

large cells with vesticular nuclei, prominent nucleoili,

glandular structures

Question 15

cryptorchidism

later association

Answer 15

testes fail to respond in hCG dependent process

germ cell tumors 4-10 times more likely

Question 16

spermatic cord vasitis nodosa

Answer 16

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

Question 17

treatment for non-seminomatous germ cell tumors

Answer 17

chemosensitive, not radiosensitive (unlike seminoma)

Question 18

most common germ cell tumor in children/infants

morphology

Answer 18

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

Question 19

main tumor marker for yolk sac tumor (endodermal sinus tumor)

Answer 19

elevated AFP

Question 20

leydig cells produce ___ in response to ___

Answer 20

Testosterone in response to LH

Question 21

most common metatases to testis

Answer 21

prostate cancer

Question 22

risk factors for testicular cancer

Answer 22

Cryptoorchid testicle (intra-abdominal is greatest risk)

Testicular feminization

Klinefelters syndrome XXY

Question 24

seminoma markers

histo

Answer 24

a-fetoprotein

B-human chorionic gonadtropin elevated

solid nests separated by fibrous spetae

lymphoid infiltrate

Question 26

leydig cell tumor morphology

Answer 26

clear cytoplasm, no nesting

sheets or random arrangements

Question 27

sertoli tumor morphology

Answer 27

closely packed cords

Question 28

adenomatoid tumor morphology

Answer 28

circumstribed, grey-white

Question 29

Choriocarcinoma prognosis

Answer 29

poorer, metatasizes to lungs and brain

sensitive to chemo