Penile and Testicular Tumors: PeIN & SCC
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Penile and Testicular Tumors: PeIN & SCC

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Questions and Answers

What is the function of Sertoli cells in the testes?

  • Endocrine secretion
  • Vascular support
  • Assist in lymphatic spread
  • Initiate spermatogenesis (correct)

    • Which type of testicular tumor is most common in males aged 25-29 years?

  • Leydig cell tumor
  • Teratoma
  • Mixed germ cell tumor
  • Germ cell tumor (correct)

    • Where do germ cell tumors commonly spread hematogenously?

  • Seminiferous tubules
  • Liver (correct)
  • Iliac nodes
  • Scrotum

    • What is the classical type of seminoma?

    <p>Bilateral seminoma</p> Signup and view all the answers

    Which of the following is NOT a known risk factor for testicular germ cell tumors?

    <p>Spermatogenic cells</p> Signup and view all the answers

    What is the most common solid tumor in males aged 15-35?

    <p>Germ cell tumor</p> Signup and view all the answers

    Which tumor is likely malignant in adults and contains cellular components derived from 2 or 3 germ layers?

    <p>Mixed germ cell tumor</p> Signup and view all the answers

    Which tumor type is generally highly curable even if advanced?

    <p>Germ cell tumor</p> Signup and view all the answers

    What does elevated AFP suggest in a testicular tumor?

    <p>Yolk sac tumor components</p> Signup and view all the answers

    What is a characteristic feature of a seminoma based on its pathologic findings?

    <p>Uniform tumor cells with clear cytoplasm</p> Signup and view all the answers

    Which seral marker is commonly abnormal in seminomas?

    <p>LDH</p> Signup and view all the answers

    Which tumor is associated with classic features such as containing 3 distinct cell types and a mucoid appearance?

    <p>Spermatocytic tumor</p> Signup and view all the answers

    Which germ cell tumor is most likely to be PLAP negative?

    <p>Choriocarcinoma</p> Signup and view all the answers

    Among the listed markers, which one is NOT a characterizing marker of a germ cell tumor with trophoblast differentiation?

    <p>AFP</p> Signup and view all the answers

    Which chromosome sequences are overrepresented in seminomas?

    <p>KRAS, CCND2, and NANOG</p> Signup and view all the answers

    Which feature distinguishes a spermatocytic tumor from classic seminoma?

    <p>Does not arise from intratubular germ cell neoplasia</p> Signup and view all the answers

    Which germ cell tumor marker is associated with germ cell tumors containing sarcomatous components?

    <p>LDH</p> Signup and view all the answers

    Which tumor is characterized by containing cytokeratin-positive cells?

    <p>Choriocarcinoma</p> Signup and view all the answers

    Which tumor is associated with the presence of large nucleoli and clear cytoplasm?

    <p>Seminoma</p> Signup and view all the answers

    What is the most common type of penile neoplasm?

    <p>Squamous Cell Carcinoma</p> Signup and view all the answers

    Which of the following is NOT a poor prognostic factor for penile squamous cell carcinoma?

    <p>Superficial invasion</p> Signup and view all the answers

    What characterizes Verrucous Carcinoma of the penis?

    <p>Pushing borders</p> Signup and view all the answers

    Which variant of Penile Intraepithelial Neoplasia is most common?

    <p>Differentiated</p> Signup and view all the answers

    What is a distinguishing feature of Bowen’s Disease?

    <p>P16 overexpression</p> Signup and view all the answers

    Which risk factor is associated with the development of Penile Intraepithelial Neoplasia?

    <p>Anal dysplasia</p> Signup and view all the answers

    What is the treatment approach for Squamous Cell Carcinoma of the penis?

    <p>Excision with or without inguinal lymph node dissection</p> Signup and view all the answers

    Which of the following architectural patterns describes the Warty variant of Penile Intraepithelial Neoplasia?

    <p>Papillary growth</p> Signup and view all the answers

    What is a common risk factor for developing Penile Squamous Cell Carcinoma?

    <p>Lichen sclerosis</p> Signup and view all the answers

    Which of the following is a poor prognostic factor for seminoma?

    <p>Presence of Sarcomatous components</p> Signup and view all the answers

    Which seral marker is abnormal in some seminomas and correlates with overall tumor burden?

    <p>Lactate dehydrogenase (LDH)</p> Signup and view all the answers

    Which of the following is a distinguishing feature of spermatocytic tumors compared to classic seminomas?

    <p>Arises from intratubular germ cell neoplasia</p> Signup and view all the answers

    Which chromosomal sequences are overrepresented in seminomas?

    <p>CCND2 and NANOG</p> Signup and view all the answers

    Which tumor type presents with cytokeratin-negative and Placental alkaline phosphatase-positive findings?

    <p>Seminoma</p> Signup and view all the answers

    Which tumor is characterized by the presence of large nuclei, clear cytoplasm, and prominent nucleoli?

    <p>Seminoma</p> Signup and view all the answers

    Which seral marker is commonly elevated in germ cell tumors with yolk sac differentiation?

    <p>AFP</p> Signup and view all the answers

    Which tumor exhibits a homogenous gray-white appearance with lobulated and bulging surfaces?

    <p>Seminoma</p> Signup and view all the answers

    Which factor is NOT a known poor prognostic factor for spermatocytic tumors?

    <p>Elevated hCG levels</p> Signup and view all the answers

    Which marker is NOT commonly associated with germ cell tumors with trophoblast differentiation?

    <p>AFP</p> Signup and view all the answers

    What is the most common seral marker for seminoma?

    <p>PLAP</p> Signup and view all the answers

    Which chromosome sequences are overrepresented in seminomas?

    <p>KRAS, CCND2, NANOG</p> Signup and view all the answers

    Which tumor is NOT associated with large nucleoli and clear cytoplasm according to its pathologic findings?

    <p>Spermatocytic Tumor</p> Signup and view all the answers

    Which tumor type is NOT examined for cytokeratin according to the text?

    <p>Seminoma</p> Signup and view all the answers

    Which tumor is characterized by variable cell sizes ranging from lymphocyte size to giant cells?

    <p>Spermatocytic Tumor</p> Signup and view all the answers

    Which tumor presents with a mucoid, edematous appearance and contains three distinct cell types?

    <p>Spermatocytic Tumor</p> Signup and view all the answers

    Which tumor marker is associated with germ cell tumors containing sarcomatous components?

    <p>LDH</p> Signup and view all the answers

    Which tumor does NOT exhibit a prominent nucleoli as part of its pathologic findings?

    <p>Spermatocytic Tumor</p> Signup and view all the answers

    Which tumor is associated with cytokeratin positivity?

    <p>Choriocarcinoma</p> Signup and view all the answers

    Which marker is overexpressed in seminomas and correlates with overall tumor burden?

    <p>PLAP</p> Signup and view all the answers

    What is the role of Sertoli cells in the testes?

    <p>Support and nourish germ cells</p> Signup and view all the answers

    Which nodes are NOT involved in the lymphatic spread of germ cell tumors?

    <p>Inguinal nodes</p> Signup and view all the answers

    What is a common risk factor for testicular germ cell tumors?

    <p>Family history</p> Signup and view all the answers

    Which histologic tumor type arises from seminiferous epithelium?

    <p>Seminoma</p> Signup and view all the answers

    What type of cells initiate spermatogenesis in the testes?

    <p>Spermatogenic cells</p> Signup and view all the answers

    Which syndrome is NOT a known risk factor for testicular germ cell tumors?

    <p>Down syndrome</p> Signup and view all the answers

    Where do germ cell tumors commonly spread hematogenously?

    <p>Liver</p> Signup and view all the answers

    Which tumor type is highly curable even if advanced?

    <p>Seminoma</p> Signup and view all the answers

    Which cell type is located in the interstitial tissue of the testes and is endocrine in nature?

    <p>Leydig cells</p> Signup and view all the answers

    Which type of testicular tumor is associated with elevated AFP suggestive of yolk sac tumor components?

    <p>Mixed germ cell tumor</p> Signup and view all the answers

    What is the most common type of spread for testicular tumors to the lymph nodes?

    <p>Periaortic nodes</p> Signup and view all the answers

    Which of the following is NOT a risk factor for testicular germ cell tumors?

    <p>Microscopic spermatic cord invasion</p> Signup and view all the answers

    Where do germ cell tumors most commonly spread hematogenously?

    <p>Liver</p> Signup and view all the answers

    Which type of spread is typical for testicular tumors to abdominal and thoracic nodes but not the inguinal nodes?

    <p>Lymphatic spread</p> Signup and view all the answers

    What is the major function of Leydig cells in the testes?

    <p>Release testosterone</p> Signup and view all the answers

    Which type of tumor is characterized by being bilateral and is considered classical seminoma?

    <p>Spermatocytic seminoma</p> Signup and view all the answers

    What is the typical histologic origin of germ cell tumors?

    <p>Seminiferous epithelium</p> Signup and view all the answers

    Which of the following risk factor is associated with the highest risk of developing a testicular germ cell tumor?

    <p>Li-Fraumeni syndrome</p> Signup and view all the answers

    What is the most common penile neoplasm characterized by low education and high poverty areas?

    <p>Squamous Cell Carcinoma</p> Signup and view all the answers

    Which variant of Penile Intraepithelial Neoplasia presents with papillary growth?

    <p>Warty</p> Signup and view all the answers

    Which tumor type is characterized by being HPV negative and does not exhibit P16 overexpression?

    <p>Verrucous Carcinoma</p> Signup and view all the answers

    Which type of tumor is associated with the presence of atypical squamous cells, large hyperchromatic irregular nuclei, and abnormal keratinization?

    <p>Squamous Cell Carcinoma</p> Signup and view all the answers

    Which neoplasm penetrates through the lamina propria with a broad base and pushing borders, leading to an excellent prognosis?

    <p>Verrucous Carcinoma</p> Signup and view all the answers

    Which pathological finding is NOT associated with Penile Intraepithelial Neoplasia?

    <p>Sharp marginated, scaly patch</p> Signup and view all the answers

    Which gene is degraded and inactivated in the pathogenesis of Squamous Cell Carcinoma of the penis?

    <p>p53</p> Signup and view all the answers

    What is the treatment approach for Bowen’s Disease characterized by sharply marginated erythematous, scaly patches?

    <p>Surgical excision</p> Signup and view all the answers

    Which tumor presents with mucoid, edematous appearance, containing three distinct cell types and has a good prognosis?

    <p>Spermatocytic tumor</p> Signup and view all the answers

    What is a common risk factor for developing Penile Squamous Cell Carcinoma?

    <p>Having a long inner foreskin</p> Signup and view all the answers

    Which marker is overexpressed in Verrucous Carcinoma of the penis and may help differentiate it from another type of neoplasm?

    <p>P16</p> Signup and view all the answers

    What is a distinguishing pathological feature of Bowen’s Disease?

    <p>Epithelial dysplasia with mitosis in the upper layer</p> Signup and view all the answers

    In Penile Intraepithelial Neoplasia, which variant is known for its papillary growth?

    <p>Warty variant</p> Signup and view all the answers

    Which of the following is a poor prognostic factor for Squamous Cell Carcinoma of the penis?

    <p>High stage</p> Signup and view all the answers

    What is a risk factor commonly associated with HPV-related penile neoplasms?

    <p>History of sexually transmitted infections</p> Signup and view all the answers

    What characterizes Verrucous Carcinoma of the penis in terms of growth?

    <p>Exophytic growth</p> Signup and view all the answers

    Which factor is NOT considered a risk factor for Bowen’s Disease?

    <p>Family history of the disease</p> Signup and view all the answers

    Which cell abnormality is characteristic of penile tumors with a poor prognosis?

    <p>Abnormal keratinization</p> Signup and view all the answers

    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

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