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58 Cards in this Set
- Front
- Back
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What are the two layers surrounding the testes?
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Tunica albuginea (inner capsule)
Tunica vaginalis (outer sac) |
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What space fills during a hydrocele?
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Tunica vaginalis
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What is the ultrastructure of the testis?
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250 lobules with 1-4 seminiferous tubules
Rete testis and efferent ductules connect seminiferous tubules to epididymis |
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Where is the location that the sperm acquire motility?
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Epididymis
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What is the site of sperm production in the testis?
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Seminferous tubules
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In the seminiferous tubules, what is found in the interstitium?
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Leydig cells
Lymphatics Vasculature |
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What is the function of leydig cells?
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Testosterone production
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In the seminiferous tubules, where are the germ cells found?
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Outside!
More mature cells are more in the center |
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Where in the seminiferous tubules are the sertoli cells located?
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Throughout the seminiferous tubule
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What's the appearance of the sertoli cells?
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Triangular or columnar
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What's the function of the sertoli cells?
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Support spermatogenesis
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What's the differential diagnosis for testicular problems?
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MINTS
M: metabolic - infertility associated problems I: infectious/inflammation N: neoplastic T: toxic S: structural/systemic |
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How do you assess metabolic-infertility associated issues of the testis?
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Biopsy
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What are you assessing in a testicular biopsy?
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Normal spermatogenesis
Hypospermatogenesis Maturation arrest Germ cell aplasia |
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What can cause infertility in the setting of normal spermatogenesis?
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Duct obstruction
Disordered motility |
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What can cause infertility in the setting of hypospermatogenesis?
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Altered hormonal states
Heat Varicocele |
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What are causes of germ cell aplasai?
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CRYPTORCHIDISM
Estrogen therapy Chemoes |
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What kinds of cells will you see on a biopsy if there is germ cell aplasia?
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Only sertoli cells!
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What's happening here?
L: normal R: abnormal |
Maturation arrest:
nothing beyond primary spermatocytes on the R |
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What's happening here? What can cause this?
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Germ cell aplasia: only sertoli cells are present
Causes: Cryptorchidism Estrogen therapy Chemo |
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What is more common: epididymitis or orchitis?
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Epididymitis!
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What are the most common causes of epididymitis?
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Chlamydia
Gonorrhea |
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What are causes of orchitis?
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Bacterial
Mycobacteria Fungal Viral |
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What condition can mimic tumors in the tetes?
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Granulomatous orchitis:
-Unilateral enlarged tender mass -Granulomas found upon biopsy |
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What is more common: testicular or epididymal tumos?
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TESTICULAR TUMORS!
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What's the most common kind of testicular tumor?
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Germ cell tumor
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What age of people get testicular cancer?
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15-34
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What race of people get testiular cancer?
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Caucasians more than african-americans
5:1 |
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What are risk factors for testicular carcinoma?
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Cryptorchidism (the contralateral testis is at risk, too!)
Testicular dysgenesis Genetic (rare) |
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What are some causes of testicular dysgensis?
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Testicular feminization
Klinefelters syndrome |
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What is the common genetic abnormality to testicular tumors?
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Isochromosome 12p: only the short arms
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What are the types of testicular tumors?
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GERM CELL TUMORS (95%)
Non-germ cell tumors: -Sex cord -Lymphomas |
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What are the types of germ cell tumors?
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Seminoma
Embryonal carcinoma Yolk sac tumor Choriocarcinoma Teratoma Mixed germ cell tumor |
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What's the most common type of testicular germ cell tumor?
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Seminoma
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What proportion of testicular germ cell tumors show single histology? Mixed?
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40% single
60% mixed Seminoma is likely to be pure. |
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What is the common originating cell for all testicular germ cell tumors?
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Intratubular germ cell neoplasia (ITGCN)
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What is the differentiation of germ cell tumors of the testis?
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What are the properties of an intratubular germ cell neoplasia?
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Malignant PREINVASIVE form of germ cell neoplasm
Confined to the seminiferous tubules |
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What's the appearance of a seminoma?
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Homogenous fleshy, gray-white
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What's the peak incidence of a seminoma?
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3rd-4th decade
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What's an effective therapy for a seminoma?
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Radiotherapy
The tumor is vulnerable to this. |
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What's the appearance of a seminoma?
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Nests of cells
Clear cytoplasm Hyperchromatic nuclei Fibrous septae infiltrated with lymphocytes NO NUCLEAR CROWDING! |
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What age do people present with an embryonal carcinoma?
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10 years YOUNGER than with a seminoma: 20-30 YO
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What's the gross appearance of a embryonal carcinoma?
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Variegated growth
Areas of hemorrhage and necrosis (it's not the homogenous appearance of the seminoma!) |
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What is the usual composition of an embryonal carcinoma?
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They present as a mixed lesion
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What type of therapy is especially effective for embryonal carcinoma?
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Chemo
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What's the microappearance of embryonal carcinoma?
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Some gland formation
Solid, sheet tumors Pleomorphic nuclei Crowding Indistinct cell membranes |
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What's the clinical course of embryonal carcinoma?
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Aggressive, in comparison to seminomas.
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What's the most common testicular tumor in kids up to 3 YO?
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Yolk sac tumor
95% of the time! IT'S ALWAYS THIS. |
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What's the marker for a yolk sac tumor?
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AFP
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What's the prognosis of a yolk sac tumor?
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Great.
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What's the characteristic histologic finding in a yolk sac tumor?
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Schiller duval body
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Other than a yolk sac tumor, what kinds of tumors do kids get?
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Teratomas
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What is the problem with postpubertal teratomas?
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Malignant!
They can met. |
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If it's a non-seminomatus tumor, what is it, most likely?
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Mixed germ cell tumor!
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What are the following markers used for:
AFP Beta HCG LDH |
AFP: yolk sac tumor
Beta HCG; choriocarcinoma LDH: not specific; assesses tumor burden |
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If someone has a combined elevated beta-HCG AND AFP, what do you think?
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NSGT
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What's the staging of testicular tumors?
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1. Confined to the testis
2: Retroperitoneal nodes below the diaphragm 3: Mets outside the retroperitoneal nodes; above diaphragm |
