Testicular Tumors (22p) – Flashcards
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Mc tumor in males between 15 & 34 y/o?
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testicular
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------- is the most significant risk for testicular cancer, increasing the risk up to 11-fold
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*cryptorchidism*
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Who has increased risk for testicular cancer: caucasians or AA?
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caucasians
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Testicular cancer is associated with accurate serum markers such as ---- and ---
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B-hCG and AFP
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MC histologic type of testicular cancer in men older than 60?
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seminoma
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What is TDS?
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Testicular dysgenesis syndrome (failure of development of testes)
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3 possible etiologies for testis cancer?
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1. cryptorchidism 2. scrotal trauma 3. trauma
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TDS includes 1. sperm = ----- 2. testicular volume less than ----- 3. cryptorchidism 4. ------spadias
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1. Poor (azospermic) 2. 12 3. hypospadias
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Association of mumps and testicular cancer? (aka the %)
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0.5%
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What foods (2) have been linked to testicular cancer?
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milk & cheese (dairy has +estrogen/progesterone)
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What is the testicular cancer susceptibility gene?
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TGCT1
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What is the MC symptom for testicular tumor?
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painless nodule/swelling of one gonad
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Name 2 possible systemic endocrine effects of a testicular tumor?
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gynecomastia/hyperthyroidism
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Yolk sac tumors are associated with high AFP or B-hCG?
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*AFP*
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Which have normal serum tumor markers? (Choose yolk sac tumor; choriocarcinoma; seminoma?)
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seminoma
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*C*horiocarcinomas are associated with elevated AFP or B-hCG?
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*b-hCg*
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Male Germ cell tumors are divided into ----- &-------
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seminomatous & non-seminomatous
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Seminomatous or nonseminomatous germ cell tumors are composed of cells that resemble primordial germ cells?
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seminomatous
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Name 5 GCT's
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seminoma; embryonal carcinoma; yolk sac tumor; teratoma and choriocarcinoma
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Of the 5 GCT's which 2 manifest usually in the first 4 years of life and always before puberty? (choose seminoma, embryonal carcnoma, yolk sac tumor; teratoma and choriocarcinoma)
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Yolk sac & teratoma (earliest)
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Infantile, Adolescent or spermatocytic seminomas are not influenced by the initiation and maintenance of spermatogenesis?
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infantile (kind of common sense, but I'd miss something stupid like this) - organoid replication
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spermatocytic seminomas only occur in what pt population? (hint- think in terms of age)
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elderly
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Intratubular testicular germ cell neoplasia (ITGCN) is also known as -----
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Carcinoma in situ
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Infantile-prepubertal is/is not preceded by ITGCN?
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NOT
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Spermtocytic seminomas are/are not preceded by ITGCN.
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NOT
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Name 2 GCT types that are NOT preceded by ITGCN (choose from the 3 categories of infantile/prepubertal; adolescent/adult; spermatocytic seminoma) .
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*infantile/prepubertal; and SS*
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*glycogen*
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Example of intratubular germ cell neoplasia. PAS stain + for abundant intracytoplasmic ----- in neoplastic cells
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Isochromosomes of the ---- (short/long) arm of chromosome ----- is a consistent marker of all *adolescent/adult CGT's*
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*short; 12*
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Normal chromosomes have ---(#) long arm and --- short arm
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1; 1
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Isochromosomes have either --- short arms or ---long arms (#)
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2; 2
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What is the critical event that transforms ITGCN into invasive carcinoma?
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acquisition of *isochromosome 12p*
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nice chart
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nice chart
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MC type of testicular germ cell tumor (50%)
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seminoma
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Seminomas are analogous to a -------tumor in the ovary.
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*dysgerminoma*
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-------- tumor is composed of sheets of uniform cells demarcated by lobules containing a moderate amount of lymphocytes.
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*seminoma*
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Classic seminoma cell is large/round to polyhedral & has a distinct cell mb with abundant --- cytoplasm (color)
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clear; "watery-appearing"
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seminoma (note cluster of *clear* cells + septa of fibrous tissue w/ lymphocytes)
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Identify the testicular tumor
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c-KIT and OCT 4 indicate ---- tumor
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seminoma
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PLAP is associated with seminomas but also with ---------
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smoking
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spermatocytic seminomas are histologically similar to ------ spermatocytes
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secondary
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Which has the potential to metastasize- seminoma or spermatocytic seminoma?
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seminoma
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spermatocytic seminoma (*3 cell types*: medium size cells predominate; giant cells and small lymphocyte-like cells)
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seminoma or spermatocytic seminoma?
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Which are reactive for PLAP- seminoma or spermatocytic seminoma?
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seminoma
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which are + for VASA seminoma or spermatocytic seminoma?
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spermatocytic seminoma
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Malignant ------ account for 2/3 of all non-seminomatous testicular cancers (choose embryonal; yolk sac; choriocarcinoma; teratoma)
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teratoma
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All cases of non-seminomatous tumors have an isochromosome ----- (letter & number)
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12p
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Which non-seminomatous GCT grows in alveolar/tubular patterns or w/ papillary convolutions? (yolk sac tumor, choriocarcinoma,embryonal carcinoma, or teratoma)
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embryonal
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*cytokeratin and CD30* are positive markers for embryonal carcinoma, yolk sac tumor, choriocarcinoma, or teratoma?
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embryonal
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yolk sac tumor (note the *schiller duval body* in 2nd picture)
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embryonal carcinoma, yolk sac tumor, choriocarcinoma, and teratoma
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Schillar-Duval bodies are characteristic of:choriocarcinoma, and teratoma, embryonal carcinoma, yolk sac tumor ?
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yolk sac
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schiller duval bodies (mesodermal core with a central capillary surrounded by 2 layers)
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This yolk sac tumor is demonstrating ---------
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Choriocarcinoma carries a median survival of --- to ---- (time)
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1-3 months
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Which tumor contains both syncytiotrophoblasts AND cytotrophoblastic cells? choriocarcinoma, and teratoma, embryonal carcinoma, yolk sac tumor ?
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choriocarcinoma (*2 cell types*; recall SS has 3)
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Prepubertal testicular teratomas derive from benign/malignant germ cells?
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benign
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Postpubertal testicular teratomas derive from benign/malignant germ cells?
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malignant
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Prepubertal or postpubertal teratomas are almost always pure (not associated w/ other germ cell tumor elements)
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pre
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Pre or postpubertal testicular teratomas usually have one or more additional germ cell tumor components?
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post
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Pre or post testicular teratomas display normal DNA and do not have isochromsome 12p
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pre
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Which is associated with ITGNC? (pre or post pubertal testicular teratoma?)
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post
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+ hcG means presence of ------ cells (synciotrophoblast/yolk sac)
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synciotrophoblast
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+AFP means --- elements are present (synciotrophoblast/yolk sac)
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yolk sac
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What cells form the sex cords? (sertoli or leydig?)
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sertoli
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Which is more common- Leydig cell tumors or sertoli cell tumors?
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leydig
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Are Leydig cells hormonally active?
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Y
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A hormonally active leydig cell means that an adult will experience- but a child will experience-----?
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(Adult=femalization/Child=masculinzation)
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Leydig (note the polyhedral)
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Sertoli or Leydig?
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*Crystals of Reinke* are pathogmnemonic for what type of tumor?
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Leydig cell tumor
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Leydig (Note Reinke's Crystals)
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Identify - Leydig or Sertoli?
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Leydig or Sertoli cell tumors present with hollow or solid tubules?
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sertoli
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Both Sertoli & Leydig cell tumors are bi/unilateral?
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uni
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-------- cell tumor of testis are well differentiated and have a prominent fibrous stroma with lobulated arrangement of tubules
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sertoli
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Describe the "hormone" secretion factors of Leydig and Sertoli cell tumors?
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(Leydig- hormonally functional; Sertoli is hormonly ((SI))lent)
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Sertoli (note the tubes!)
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What type of testicular tumor is this?
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Direct derivative of ITGCN?
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seminoma
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Embryonal CA will/will not invade tunica albuginea & shows foci of --- or ---
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will invade TA; hemorrhage or necrosis
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T/F: Embryonal CA *lacks* well-formed glands
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True (UNlike teratomas)
