84 Questions
What is the function of Sertoli cells in the testes?
Initiate spermatogenesis
Which type of testicular tumor is most common in males aged 25-29 years?
Germ cell tumor
Where do germ cell tumors commonly spread hematogenously?
Liver
What is the classical type of seminoma?
Bilateral seminoma
Which of the following is NOT a known risk factor for testicular germ cell tumors?
Spermatogenic cells
What is the most common solid tumor in males aged 15-35?
Germ cell tumor
Which tumor is likely malignant in adults and contains cellular components derived from 2 or 3 germ layers?
Mixed germ cell tumor
Which tumor type is generally highly curable even if advanced?
Germ cell tumor
What does elevated AFP suggest in a testicular tumor?
Yolk sac tumor components
What is a characteristic feature of a seminoma based on its pathologic findings?
Uniform tumor cells with clear cytoplasm
Which seral marker is commonly abnormal in seminomas?
LDH
Which tumor is associated with classic features such as containing 3 distinct cell types and a mucoid appearance?
Spermatocytic tumor
Which germ cell tumor is most likely to be PLAP negative?
Choriocarcinoma
Among the listed markers, which one is NOT a characterizing marker of a germ cell tumor with trophoblast differentiation?
AFP
Which chromosome sequences are overrepresented in seminomas?
KRAS, CCND2, and NANOG
Which feature distinguishes a spermatocytic tumor from classic seminoma?
Does not arise from intratubular germ cell neoplasia
Which germ cell tumor marker is associated with germ cell tumors containing sarcomatous components?
LDH
Which tumor is characterized by containing cytokeratin-positive cells?
Choriocarcinoma
Which tumor is associated with the presence of large nucleoli and clear cytoplasm?
Seminoma
What is the most common type of penile neoplasm?
Squamous Cell Carcinoma
Which of the following is NOT a poor prognostic factor for penile squamous cell carcinoma?
Superficial invasion
What characterizes Verrucous Carcinoma of the penis?
Pushing borders
Which variant of Penile Intraepithelial Neoplasia is most common?
Differentiated
What is a distinguishing feature of Bowen’s Disease?
P16 overexpression
Which risk factor is associated with the development of Penile Intraepithelial Neoplasia?
Anal dysplasia
What is the treatment approach for Squamous Cell Carcinoma of the penis?
Excision with or without inguinal lymph node dissection
Which of the following architectural patterns describes the Warty variant of Penile Intraepithelial Neoplasia?
Papillary growth
What is a common risk factor for developing Penile Squamous Cell Carcinoma?
Lichen sclerosis
Which of the following is a poor prognostic factor for seminoma?
Presence of Sarcomatous components
Which seral marker is abnormal in some seminomas and correlates with overall tumor burden?
Lactate dehydrogenase (LDH)
Which of the following is a distinguishing feature of spermatocytic tumors compared to classic seminomas?
Arises from intratubular germ cell neoplasia
Which chromosomal sequences are overrepresented in seminomas?
CCND2 and NANOG
Which tumor type presents with cytokeratin-negative and Placental alkaline phosphatase-positive findings?
Seminoma
Which tumor is characterized by the presence of large nuclei, clear cytoplasm, and prominent nucleoli?
Seminoma
Which seral marker is commonly elevated in germ cell tumors with yolk sac differentiation?
AFP
Which tumor exhibits a homogenous gray-white appearance with lobulated and bulging surfaces?
Seminoma
Which factor is NOT a known poor prognostic factor for spermatocytic tumors?
Elevated hCG levels
Which marker is NOT commonly associated with germ cell tumors with trophoblast differentiation?
AFP
What is the most common seral marker for seminoma?
PLAP
Which chromosome sequences are overrepresented in seminomas?
KRAS, CCND2, NANOG
Which tumor is NOT associated with large nucleoli and clear cytoplasm according to its pathologic findings?
Spermatocytic Tumor
Which tumor type is NOT examined for cytokeratin according to the text?
Seminoma
Which tumor is characterized by variable cell sizes ranging from lymphocyte size to giant cells?
Spermatocytic Tumor
Which tumor presents with a mucoid, edematous appearance and contains three distinct cell types?
Spermatocytic Tumor
Which tumor marker is associated with germ cell tumors containing sarcomatous components?
LDH
Which tumor does NOT exhibit a prominent nucleoli as part of its pathologic findings?
Spermatocytic Tumor
Which tumor is associated with cytokeratin positivity?
Choriocarcinoma
Which marker is overexpressed in seminomas and correlates with overall tumor burden?
PLAP
What is the role of Sertoli cells in the testes?
Support and nourish germ cells
Which nodes are NOT involved in the lymphatic spread of germ cell tumors?
Inguinal nodes
What is a common risk factor for testicular germ cell tumors?
Family history
Which histologic tumor type arises from seminiferous epithelium?
Seminoma
What type of cells initiate spermatogenesis in the testes?
Spermatogenic cells
Which syndrome is NOT a known risk factor for testicular germ cell tumors?
Down syndrome
Where do germ cell tumors commonly spread hematogenously?
Liver
Which tumor type is highly curable even if advanced?
Seminoma
Which cell type is located in the interstitial tissue of the testes and is endocrine in nature?
Leydig cells
Which type of testicular tumor is associated with elevated AFP suggestive of yolk sac tumor components?
Mixed germ cell tumor
What is the most common type of spread for testicular tumors to the lymph nodes?
Periaortic nodes
Which of the following is NOT a risk factor for testicular germ cell tumors?
Microscopic spermatic cord invasion
Where do germ cell tumors most commonly spread hematogenously?
Liver
Which type of spread is typical for testicular tumors to abdominal and thoracic nodes but not the inguinal nodes?
Lymphatic spread
What is the major function of Leydig cells in the testes?
Release testosterone
Which type of tumor is characterized by being bilateral and is considered classical seminoma?
Spermatocytic seminoma
What is the typical histologic origin of germ cell tumors?
Seminiferous epithelium
Which of the following risk factor is associated with the highest risk of developing a testicular germ cell tumor?
Li-Fraumeni syndrome
What is the most common penile neoplasm characterized by low education and high poverty areas?
Squamous Cell Carcinoma
Which variant of Penile Intraepithelial Neoplasia presents with papillary growth?
Warty
Which tumor type is characterized by being HPV negative and does not exhibit P16 overexpression?
Verrucous Carcinoma
Which type of tumor is associated with the presence of atypical squamous cells, large hyperchromatic irregular nuclei, and abnormal keratinization?
Squamous Cell Carcinoma
Which neoplasm penetrates through the lamina propria with a broad base and pushing borders, leading to an excellent prognosis?
Verrucous Carcinoma
Which pathological finding is NOT associated with Penile Intraepithelial Neoplasia?
Sharp marginated, scaly patch
Which gene is degraded and inactivated in the pathogenesis of Squamous Cell Carcinoma of the penis?
p53
What is the treatment approach for Bowen’s Disease characterized by sharply marginated erythematous, scaly patches?
Surgical excision
Which tumor presents with mucoid, edematous appearance, containing three distinct cell types and has a good prognosis?
Spermatocytic tumor
What is a common risk factor for developing Penile Squamous Cell Carcinoma?
Having a long inner foreskin
Which marker is overexpressed in Verrucous Carcinoma of the penis and may help differentiate it from another type of neoplasm?
P16
What is a distinguishing pathological feature of Bowen’s Disease?
Epithelial dysplasia with mitosis in the upper layer
In Penile Intraepithelial Neoplasia, which variant is known for its papillary growth?
Warty variant
Which of the following is a poor prognostic factor for Squamous Cell Carcinoma of the penis?
High stage
What is a risk factor commonly associated with HPV-related penile neoplasms?
History of sexually transmitted infections
What characterizes Verrucous Carcinoma of the penis in terms of growth?
Exophytic growth
Which factor is NOT considered a risk factor for Bowen’s Disease?
Family history of the disease
Which cell abnormality is characteristic of penile tumors with a poor prognosis?
Abnormal keratinization
Study Notes
Testicular Tumors
- 30-50% of testicular germ cell tumors are seminomas, also present in mediastinum, pineal gland (germinoma), and retroperitoneum
- 3 elevations in serum: PLAP (placental alkaline phosphatase), LDH (Lactate dehydrogenase), and hCG (Human chorionic gonadotropin)
- Overrepresentation of 12p chromosome sequences, probably KRAS, CCND2, and NANOG
Seminoma Pathologic Findings
- Homogenous well demarcated gray-white with lobulated and bulging cut surface
- Uniform tumor cells with clear cytoplasm (glycogen contents)
- Prominent cell border, large nuclei, and prominent nucleoli
- PLAP (+), Cytokeratin (-), and AFP (normal)
Spermatocytic Tumor
- NOT related to classic seminoma, does NOT arise from intratubular germ cell neoplasia
- Treatment: Orchiectomy
- Poor prognostic factor: Sarcomatous components
- PLAP (-), hCG (-), and AFP (-)
- Pathologic findings: Pale gray, mucoid, edematous, contains 3 cell types (varying from lymphocyte size to giant cells)
Choriocarcinoma
- Cytotrophoblast and Syncytiotrophoblast
- PLAP (+), Cytokeratin (+), and hCG
Testicular Anatomy
- Tunica vaginalis: extension of peritoneal cavity
- Tunica albuginea: fibrous capsule extending into testis, separates into lobules
- Tunica vasculosa: Vascular layer
- Histology of Testes:
- Spermatogenic cells: initiate spermatogenesis
- Sertoli cells: Located in seminiferous tubules
- Leydig cells: In interstitial tissue, endocrine in nature
Penile and Testicular Tumors
- Penile Intraepithelial Neoplasia (PeIN): Intraepithelial squamous cell atypia
- Four variants: Differentiated, Warty, Basaloid, and Warty basaloid
- Squamous Cell Carcinoma: Most common penile neoplasms, low education, high poverty areas
- Risk factors: Long inner foreskin, HPV, Lichen sclerosis
- Types: Bowen's Dz (in situ), Verrucous Carcinoma
Learn about Penile Intraepithelial Neoplasia (PeIN) and Squamous Cell Carcinoma (SCC) in penile tumors, including associated risk factors and pathogenesis. Discover the variants of PeIN and common characteristics of these penile neoplasms.
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