Tumors of the Testis

Question 1

What is the cytogenic marker for most testicular tumors?

Answer 1

isochromosome p12

Question 2

To where do testicular tumors metastasize?

Answer 2

Periaortic abdominal lymph nodes

Question 3

What are the only documented risk factors for testicular tumors?

Answer 3

Cryptorchidism and Gonadal Dysgenesis

Question 4

What is the most common initial step of testicular tumorigenesis?

Answer 4

Intratubular testicular germ cell neoplasia (ITGCN)

Question 5

How are testicular tumors classified?

Answer 5

Basis of their cell of origin

Question 6

From what do seminomas arise?

Answer 6

Malignant cells that retain phenotypic features of spermatogonia

Question 7

What type of cells make up a teratocarcinoma?

Answer 7

Malig. undiff. embryonal carcinoma cells and somatic extraembryonic derivatives

Question 8

What is the name of the tumor containing undifferentiated embryonal cells?

Answer 8

Embryonal carcinoma

Question 9

What are nonseminomatous germ cell tumors?

Answer 9

All germ cell tumors with embryonal carcinoma as their malignant stem cells

Question 10

What is intratubular germ cell neoplasia?

Answer 10

Testicular carcinoma in situ

Question 11

What does ITGCN represent?

Answer 11

Preinvasive form of germ cell tumors

Question 12

What two markers are reliable for ID’ing ITGCN?

Answer 12

Placental alkaline phosphatase and OCT3/4

Question 13

What is ITGCN a precursor for?

Answer 13

Invasive carcinoma

Question 14

This biopsy shows seminiferous tubules showing NO signs of spermatogenesis and instead contain large atypical cells. Dx?

Answer 14

Intratubular Germ Cell Neoplasia

Question 15

What type of cells do seminomas typically contain?

Answer 15

Monomorphous Cells resembling spermatogonia

Question 16

What is seminoma equivalent to uscopically?

Answer 16

Ovarian dysgerminoma

Question 17

What are reliable markers for seminomas?

Answer 17

• Placental Alkaline Phosphatase
• c-KIT
• OCT3/4

Question 18

What are the two subtypes of seminoma?

Answer 18

1. Seminoma with Syncytiotrophoblastic Giant Cells
2. Anaplastic Seminoma

Question 19

From what are nonseminomatous germ cells derived?

Answer 19

Embryonal Cells

Question 20

What are the two typical types of NSGCTs?

Answer 20

1. Pure Embryonal carcinoma
2. Teratocarcinomas

Question 21

Embryonal carcinoma component of a nonseminomatous germ cell tumor is shown. What are the typical findings?

Answer 21

Scant cytoplasm, hyperchromatic nuclei, bluish color

Question 22

What markers are used to ID embryonal carcinoma? How can these tumors be differentiated from seminomas?

Answer 22

Placental Alkaline Phosphatase, OCT3/4; ECs express cytokeratins and CD30 but NOT c-KIT

Question 23

For what cancer are embryonal carcinoma cells the stem cells?

Answer 23

Teratocarcinoma (malignant teratomas)

Question 24

What cells are contained w/i choriocarcinomas?

Answer 24

Malignant chorionic epithelium

Question 25

What components are contained w/i NSGCTs compared to seminomas?

Answer 25

Yolk sac components and syncytiotrophoblastic cells

Question 26

What are two reliable tumor markers used for detecting NSGCTs?

Answer 26

Alpha fetoprotein and human chorionicgonadotropin

Question 27

Glomeruloid Schiller-Duval bodies are shown. What is the Dx?

Answer 27

Yolk Sac Tumor

Question 28

What are gonadal stromal tumors composed of?

Answer 28

Cells that resemble sertoli/leydig cells

Question 29

A Leydig Cell Tumor is shown. What is the morphology observed?

Answer 29

Renke crystals - eosinophilic cytoplasmic inclusions

Question 30

What do Leydig Cell Tumors lead to in prepubertal boys?

Answer 30

Precocious physical and sexual development

Question 31

Neoplastic cells arranged in tubules surrounded by a basement membrane is shown. The tumor is generally not malignant. What is the Dx?

Answer 31

Sertoli Cell Tumor

Question 32

From what do adenomatoid tumors arise?

Answer 32

Mesothelial layer of the tunica vaginalis (benign)

Question 33

In what population is malignant lymphoma the most common neoplasm of the testes?

Answer 33

Men \> 60 yo