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19 Cards in this Set
- Front
- Back
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name 4 causes of testicular infertility and explain each
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normal bx (obstruction)
immature (leydig cells dormant, seminiferous tubules primitive due to low LH and FSH maturation arrest (stuck at primary spermatocyte) hypospermatogenesis (few germ cells) germ cell aplasia (no germ cells at all) |
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name and explain the 2 causes of testicular dysgenesis
name what can happen with these patients |
testicular feminization: everything male except genitalia, 46 XY, due to testosterone insensitivity
klinefelters (47 XXY): elongated body, small testes, LH and FSH up, testosterone down > seminiferous tubule atrophy and fibrosis increased infertility and risk of getting germ cell tumors |
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how does cryptorchism occur?
what does it increase the risk of? |
either defect in mullerian duct inhibiting factor (transabdominal phase) or androgens (inguinoscrotal phase - more common)
infertility and germ cell neoplasia |
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how does tension of testis cause trouble?
in what ages is it normally found in? how does it present clinically? is it a urologic emergency? |
twisting of spermatic cord in kids/teens causing pain and can lead to hemorrhage (venous obstruction) or ischemia (arterial obstruction). it is a urologic emergency (6 hrs)
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name and describe 3 testicular inflammatory disorders
which structures do inflam disorders affect more? what are the exceptions? |
acute ependymitis/orchitis (reflux leads to infection)
mumps orchitis (testicular pain/swelling w/ lymphoplasmocytic inflammation after mumps) idiopathic granulomatous orchitis (granulomatous rxn due to vascular injury, trauma, or autoimmune rxn to spermatozoa > watch for sarcoidosis, granulomas, and seminomas first) usually epididymis (except for syphilis and mumps) |
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what is intratubular germ cell neoplasia?
where is it seen? |
tumor cells confined to seminiiferous tubules
seen in normal testis, infertility, testicular dysgenesis, cryptorchid testis |
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how does a seminoma look grossly?
how does it look histologically? what age range do you normally see it? |
well circumscribed, lobulated, gray-white w/o hemorrhage or necrosis
large, polyhedral cells w/ prominent nucleoli and large nuclei, lots of glycogen. either lymphocytic of granulomatuous infiltrate 30-50 yrs |
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what does a spermatocytic seminoma look like grossly?
what does it look like histologically? where do they metastasize |
large, bulky, not hemorrhagic or necrotic.
look like small, pleomorphic 2ndary spermatocytes spermatocytic seminomas do not metastasize! |
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how does an embryonal carcinoma look grossly?
how does it look histologically? what age group normally has it? what's more aggressive, seminoma or embryonal carcinoma? |
hemorrhagic, necrotic, poorly demarcated
necrotic, pleomorphic, eosinophilic cells = dirty anaplastic tumor 20-30 yrs embryonal carcinoma ismore aggressive |
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how does a yolk sac tumor look histologically?
what do yolk sac tumors secrete? at what age are they most common? |
lacy w/ schiller duval bodies
secrete AFP infants |
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what is necessary for a diagnosis of choriocarcinoma?
how do they look grossly? what do they secrete? |
cytotrophoblasts (don't stain HCG) and synctiotrophoblasts (stain HCG)
hemorrhagic and necrotic secerete HCG |
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what elements does a teratoma have?
are they benign or malignant? how do they manifest? |
ectodermal, mesodermal, and endodermal elements
benign before puberty, malignant after puberty skin formations, neural-glial brain formations |
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what is the most common germ cell tumor?
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mixed germ cell tumor
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how do you stage germ cell tumors?
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I - confined to testis
II - limited to retroperitoneal LN below diaphragm III - outside or above retroperitoneal LN of diaphragm |
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if a YOUNG man presents with retroperitoneal masses, what should be first on your differential?
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lymphoma or metastatic germ cell tumor
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which are more aggressive, seminomas or non-seminomatous germ cell tumors?
what therapy would you use for seminomas? for NSGCTs? |
NSGCTs are more aggressive and present with higher grade
semionmas = radiation, NSGCTs = chemo |
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how do leydig cells tumors work and what do they cause?
are they benign or malignant? how do they look grossly? how do they look histologically? |
secerete excess androgens causing sexual precocity
benign (mostly) gross: well-circumscribed, mahogany brown histology: big, pink cells w/ bland nuclei and reinke crystals |
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how do sertoli cell tumors work?
how do they look histologically? are the benign or malignant |
secrete androgens, but at lower levels
resemble seminiferous tubules benign (mostly) |
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what is the most common testis tumor in men over 60 years old?
how is its grade and prognosis? how does it look histologically? |
lymphoma
high grade, poor prognosis neoplastic lymphod cells surround seminiferous tubules |
