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Questions and Answers

What percentage of testicular tumors are germ cell tumors?

50%

100%

95% (correct)

10%

Cryptorchidism is identified as a risk factor for testicular tumors.

True

Name one specific infection that can lead to epididymitis.

N.gonorrhea

The most common germ cell tumor is called a __________.

seminoma Signup and view all the answers

Which testicular tumor marker is associated with yolk sac tumors?

AFP Signup and view all the answers

Match the following testicular tumors with their characteristics:

Seminoma = Most common in males in their 40’s and radiosensitive Choriocarcinoma = Highly malignant and trophoblastic differentiation Yolk sac tumor = Most often seen in children with Schiller-Duval bodies Embryonal carcinoma = 30’s, 50% mixed with immature glands Signup and view all the answers

Non-seminomas are usually more curable than seminomas.

False Signup and view all the answers

Epididymitis secondary to bacterial UTI is considered __________ inflammation.

non-specific Signup and view all the answers

Which of the following is a type of tumor associated with the testis?

Germ cell tumors Signup and view all the answers

Which of the following is a known risk factor associated with cryptorchidism?

Tubular atrophy and germ cell deficiency Signup and view all the answers

Cryptorchidism can lead to increased risk of testicular cancer.

True Signup and view all the answers

What is the most common symptom of testicular torsion?

Sudden pain in the testis Signup and view all the answers

Testicular torsion is primarily caused by viral infections.

False Signup and view all the answers

What does PIN stand for in the context of prostate pathology?

Prostate Intraepithelial Neoplasm Signup and view all the answers

Epididymitis is primarily caused by __________ infections.

bacterial Signup and view all the answers

Match the following conditions with their characteristics:

Cryptorchidism = Undescended testis Testicular torsion = Twisting of the spermatic cord Epididymitis = Inflammation of the epididymis Germ cell tumors = Most common testicular tumors Signup and view all the answers

Germ cell tumors arise from _ cells in the testis.

germ Signup and view all the answers

Sex-cord stromal tumors in the testis are typically associated with what?

Hormonal imbalances Signup and view all the answers

Match the following conditions with their descriptions:

Cryptorchidism = Testes fails to descend Testicular torsion = Acute vascular event Epididymitis = Inflammation of the epididymis Sex-cord stromal tumors = Tumors arising from non-germinal tissue Signup and view all the answers

Testicular torsion is a medical emergency that requires immediate attention.

True Signup and view all the answers

Which ISUP grade group corresponds to a Gleason score of 3 + 4?

Grade group 2 Signup and view all the answers

What is a common treatment option for patients with testicular torsion?

Surgery Signup and view all the answers

Prostate Intraepithelial Neoplasm (PIN) is only found in advanced stages of prostate cancer.

False Signup and view all the answers

What is one potential consequence of testicular torsion?

Infertility Signup and view all the answers

Study Notes

Pathology of the Testis

Inflammation of the epididymis (epididymitis) can be caused by specific infections like gonorrhea, mumps, and tuberculosis, or non-specific infections secondary to bacterial urinary tract infections (UTIs).
Inflammation of the testis (orchitis) can also be caused by specific or non-specific infections.

Testicular Tumors

Testicular tumors are generally painless masses affecting around 5 out of every 100,000 males, commonly occurring between ages 15-35.
There are two main types: germ cell tumors (95%) and sex cord-stromal tumors (5%).
Germ cell tumors can be further classified into seminomas and non-seminomatous germ cell tumors (NSGCTs).

Germ Cell Tumors

Germ cell tumors constitute 95% of testicular neoplasms and account for 10% of cancer deaths in young adults.
Risk factors for germ cell tumors include cryptorchidism (undescended testicle) and gonadal dysgenesis (abnormal development of the gonads).
An intratubular germ cell neoplasia (precursor), often with a specific chromosomal abnormality (isochromosome in chr.12p), can lead to these tumors.
Seminomas are different from NSGCTs in terms of their clinical behavior, spread, sensitivity to treatment, and markers.

Seminoma vs NSGCTs

Seminomas, the most common germ cell tumor, typically occurs in men in their 40s.
They are characterized by a white-yellow "potato" appearance with clear cells in sheets or tubules.
Lymphocytes and granulomas are often found.
Markers for seminomas include PLAP, C-kit, and Oct-4.
Seminomas spread primarily through lymphatics and are radiosensitive.
NSGCTs, including embryonal carcinoma, yolk sac tumor, choriocarcinoma, and teratoma, are usually present in later stages.
NSGCTs spread hematogenously and are radioresistant.
NSGCTs are associated with the production of serum hCG (human chorionic gonadotropin) and AFP (alpha-fetoprotein).

NSGCT Subtypes

Embryonal carcinoma: Present in 30% of NSGCTs, often mixed with other subtypes.
Yolk sac tumor: Most common in children. Contains Schiller-Duval bodies and elevates AFP levels.
Choriocarcinoma: A highly malignant type, shows trophoblastic differentiation and elevates HCG levels.
Teratoma: Occurs in both adults and infants, commonly mixed with other subtypes. Shows multipotential differentiation of tissues from all three germ layers (ectoderm, endoderm, and mesoderm) and is generally considered a low-grade tumor.

Gleason Grading & ISUP CaP Grading System

The Gleason grading system, developed by pathologist Donald Gleason in 1966, is used to assess the degree of differentiation in prostate cancer.
The ISUP (International Society of Urological Pathology) grading system, introduced in 2016, is now widely used.
ISUP grade groups range from 1 (low grade) to 5 (high grade).

Carcinoma of the Prostate

Prostate cancer is one of the most common cancers in men, typically affecting those over 65 years of age.
The pathogenesis is complex and likely involves a combination of aging, genetics (heredity, ethnicity), and environmental factors (carcinogens, diet).
Prostate cancer is androgen-dependent, meaning it relies on the male hormone testosterone for growth.
Treatment options include hormonal therapy (medical castration), surgery, and radiation.
Serum PSA levels are monitored following treatment.
PIN (Prostate Intraepithelial Neoplasm) is a precancerous lesion associated with an increased risk of prostate cancer.

PIN involves the proliferation of atypical cells with features like nuclear enlargement, overlapping, hyperchromatism (dark-staining), and prominent nucleoli.
It has a similar incidence, distribution, and cellular features to prostate cancer.
70% of cases are associated with prostate cancer.

Pathology of the Prostate: Other Conditions

Nodular Hyperplasia (BPH): Benign enlargement of the prostate, common in men over 50 years old.
BPH can cause symptoms like dysuria, frequency, and nocturia.
BPH is thought to be hormonally dependent, with testosterone playing a role.
BPH usually does not increase the risk of prostate cancer.

Pathology of the Testis: Other Conditions.

Cryptorchidism: Undescended testicle, a congenital condition affecting 1% of the population.
Cryptorchidism can lead to testicular atrophy, germ cell deficiency, and infertility.
Cryptorchidism is associated with a 3-5 fold increased risk of testicular cancer.
Testicular Torsion: A medical emergency involving twisting of the spermatic cord, leading to obstruction of the blood supply.