Tumors of the Testis Flashcards
What is the cytogenic marker for most testicular tumors?
isochromosome p12
To where do testicular tumors metastasize?
Periaortic abdominal lymph nodes
What are the only documented risk factors for testicular tumors?
Cryptorchidism and Gonadal Dysgenesis
What is the most common initial step of testicular tumorigenesis?
Intratubular testicular germ cell neoplasia (ITGCN)
How are testicular tumors classified?
Basis of their cell of origin
From what do seminomas arise?
Malignant cells that retain phenotypic features of spermatogonia
What type of cells make up a teratocarcinoma?
Malig. undiff. embryonal carcinoma cells and somatic extraembryonic derivatives
What is the name of the tumor containing undifferentiated embryonal cells?
Embryonal carcinoma
What are nonseminomatous germ cell tumors?
All germ cell tumors with embryonal carcinoma as their malignant stem cells
What is intratubular germ cell neoplasia?
Testicular carcinoma in situ
What does ITGCN represent?
Preinvasive form of germ cell tumors
What two markers are reliable for ID’ing ITGCN?
Placental alkaline phosphatase and OCT3/4
What is ITGCN a precursor for?
Invasive carcinoma
This biopsy shows seminiferous tubules showing NO signs of spermatogenesis and instead contain large atypical cells. Dx?
Intratubular Germ Cell Neoplasia
What type of cells do seminomas typically contain?
Monomorphous Cells resembling spermatogonia
What is seminoma equivalent to uscopically?
Ovarian dysgerminoma
What are reliable markers for seminomas?
- Placental Alkaline Phosphatase
- c-KIT
- OCT3/4
What are the two subtypes of seminoma?
- Seminoma with Syncytiotrophoblastic Giant Cells
- Anaplastic Seminoma
From what are nonseminomatous germ cells derived?
Embryonal Cells
What are the two typical types of NSGCTs?
- Pure Embryonal carcinoma
- Teratocarcinomas
Embryonal carcinoma component of a nonseminomatous germ cell tumor is shown. What are the typical findings?
Scant cytoplasm, hyperchromatic nuclei, bluish color
What markers are used to ID embryonal carcinoma? How can these tumors be differentiated from seminomas?
Placental Alkaline Phosphatase, OCT3/4; ECs express cytokeratins and CD30 but NOT c-KIT
For what cancer are embryonal carcinoma cells the stem cells?
Teratocarcinoma (malignant teratomas)
What cells are contained w/i choriocarcinomas?
Malignant chorionic epithelium
What components are contained w/i NSGCTs compared to seminomas?
Yolk sac components and syncytiotrophoblastic cells
What are two reliable tumor markers used for detecting NSGCTs?
Alpha fetoprotein and human chorionicgonadotropin
Glomeruloid Schiller-Duval bodies are shown. What is the Dx?
Yolk Sac Tumor
What are gonadal stromal tumors composed of?
Cells that resemble sertoli/leydig cells
A Leydig Cell Tumor is shown. What is the morphology observed?
Renke crystals - eosinophilic cytoplasmic inclusions
What do Leydig Cell Tumors lead to in prepubertal boys?
Precocious physical and sexual development
Neoplastic cells arranged in tubules surrounded by a basement membrane is shown. The tumor is generally not malignant. What is the Dx?
Sertoli Cell Tumor
From what do adenomatoid tumors arise?
Mesothelial layer of the tunica vaginalis (benign)
In what population is malignant lymphoma the most common neoplasm of the testes?
Men > 60 yo
