L4 (T3): Pathology of the testis
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Questions and Answers

Which age group most commonly experiences acute epididymo-orchitis?

  • Men aged 20 – 39 years (correct)
  • Men aged 40 – 59 years
  • Men aged 80 years and above
  • Men aged 60 – 79 years

    • What are the most common sexually transmitted diseases associated with acute epididymo-orchitis?

  • Syphilis and Trichomoniasis
  • Herpes simplex virus and Human papillomavirus
  • Hepatitis B virus and Human immunodeficiency virus
  • Chlamydia trachomatis and Neisseria gonorrhoea (correct)

    • What is the most common cause of acute epididymo-orchitis in older men over 40 years?

  • Streptococcus pneumoniae
  • Staphylococcus aureus
  • Haemophilus influenzae
  • E. coli (correct)

    • What is the classification of testicular cancer into?

    <p>Seminomatous and non-seminomatous germ cell tumours</p> Signup and view all the answers

    What age group commonly experiences most cases of acute epididymo-orchitis?

    <p>20 – 39 years</p> Signup and view all the answers

    What are the predisposing factors of testicular cancer?

    <p>Undescended testis and family history of testicular cancer</p> Signup and view all the answers

    What are the biochemical and radiological investigations for testicular cancer?

    <p>Tumor markers and ultrasound</p> Signup and view all the answers

    What are the radiological, gross and histological features of testicular seminoma, teratoma and other germ cell tumors?

    <p>Seminoma: Homogeneous mass; Teratoma: Solid and cystic components; Other germ cell tumors: Variable appearance</p> Signup and view all the answers

    What is the basic understanding of staging and prognosis of testicular cancer?

    <p>Staging is based on TNM system; Prognosis is generally good, especially for early stages</p> Signup and view all the answers

    What is the basic understanding of treatment of testicular cancer?

    <p>Surgery, chemotherapy, and radiation therapy</p> Signup and view all the answers

    Which type of testicular cancer is the most common in men aged 30-34?

    <p>Seminomatous germ cell tumors</p> Signup and view all the answers

    What is the characteristic feature of seminomas?

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

    What is the most common cause of acute epididymo-orchitis?

    <p>Inflammation and neutrophil predominance</p> Signup and view all the answers

    What is the recommended timeframe for 'untwisting' the spermatic cord in cases of torsion?

    <p>Within 6 hours</p> Signup and view all the answers

    What is the most common type of non-seminomatous germ cell tumor?

    <p>Embryonal carcinoma</p> Signup and view all the answers

    What is the primary management approach for acute epididymo-orchitis?

    <p>Culture and sensitivity testing, antibiotics, pain relief, and scrotal elevation</p> Signup and view all the answers

    What is the potential consequence of chronic epididymo-orchitis?

    <p>Scarring and sterility</p> Signup and view all the answers

    Which factor is NOT associated with an increased risk of testicular cancer?

    <p>Exposure to estrogen</p> Signup and view all the answers

    What is the most common presentation of torsion?

    <p>Sudden testicular pain</p> Signup and view all the answers

    Which type of testicular cancer occurs in men in their late teens and early 30s?

    <p>Non-seminomatous germ cell tumors</p> Signup and view all the answers

    Which tumor marker is associated with choriocarcinoma and embryonal carcinoma?

    <p>Human chorionic gonadotropin (HCG)</p> Signup and view all the answers

    What is the characteristic macroscopic appearance of seminoma?

    <p>Potato-like appearance with no haemorrhage or necrosis</p> Signup and view all the answers

    What is the most likely diagnosis for a 22-year-old with a testicular mass showing partly cystic and partly solid appearances on ultrasound, and normal tumor markers?

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

    What is the common presentation of advanced testicular cancer with metastases to the lungs?

    <p>Cough, chest pain, haemoptysis and shortness of breath</p> Signup and view all the answers

    What is the primary purpose of a PET scan in testicular cancer management?

    <p>To detect recurrent disease after treatment</p> Signup and view all the answers

    What is the microscopic feature of seminoma cells?

    <p>Large with prominent lymphocytic infiltrate</p> Signup and view all the answers

    What is the most likely diagnosis for a 32-year-old man with heterogeneous bilateral testicular tumors and mixed cystic and solid components on CT scan?

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

    What is the primary role of tumor markers in testicular cancer?

    <p>To aid in making a diagnosis of cancer in the presence of a testicular mass</p> Signup and view all the answers

    What is the characteristic macroscopic appearance of early teratoma?

    <p>Irregular tumour with cystic cut surface and mucin secretion</p> Signup and view all the answers

    What is the imaging modality of choice to distinguish between a complex cyst (most likely malignant) and a simple cyst (most likely benign) in testicular cancer?

    <p>Ultrasound scan (USS)</p> Signup and view all the answers

    Which type of testicular cancer is commonly associated with increased levels of alpha-fetoprotein and human chorionic gonadotropin?

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

    What is the most common cause of acute epididymo-orchitis in older men over 40 years?

    <p>Escherichia coli</p> Signup and view all the answers

    What is the primary imaging modality of choice to distinguish between a complex cyst (most likely malignant) and a simple cyst (most likely benign) in testicular cancer?

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

    What is the characteristic microscopic feature of seminoma cells?

    <p>Schiller-Duval bodies</p> Signup and view all the answers

    What is the primary management approach for acute epididymo-orchitis?

    <p>Antibiotic therapy</p> Signup and view all the answers

    Which factor is NOT associated with an increased risk of testicular cancer?

    <p>History of vasectomy</p> Signup and view all the answers

    Which type of testicular cancer tends to grow and spread more slowly than non-seminomatous tumors?

    <p>Seminomatous tumors</p> Signup and view all the answers

    Which exposure is associated with a higher risk of testicular cancer in males?

    <p>Exposure to estrogen in utero</p> Signup and view all the answers

    What is the most common type of testicular cancer, with over 90% of testicular cancers arising from it?

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

    What is the primary risk factor for developing testicular cancer?

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

    Which type of testicular tumors are classified into germ cell tumors and sex cord-stromal tumors?

    <p>Testicular lymphoma</p> Signup and view all the answers

    What is the most common subtype of testicular cancer affecting men between 25 and 45 years of age?

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

    What is the recommended management for acute epididymo-orchitis?

    <p>Antibiotics, pain relief, and supportive care</p> Signup and view all the answers

    What is the macroscopic appearance of normal testes?

    <p>Yellow-brown appearance and soft seminal tubules</p> Signup and view all the answers

    What is the age group most commonly affected by acute epididymo-orchitis?

    <p>22-39 years</p> Signup and view all the answers

    What is the characteristic feature of seminomas?

    <p>Sheets of uniform cells with clear cytoplasm and central nuclei</p> Signup and view all the answers

    What is the common presentation of advanced testicular cancer with lung metastases?

    <p>Dyspnea and non-productive cough</p> Signup and view all the answers

    What is the primary focus of the lecture regarding testicular cancer classification?

    <p>Clinical, biological, and radiological investigations</p> Signup and view all the answers

    Which type of testicular tumor is common in men in their teens or early thirties?

    <p>Embryonal carcinoma</p> Signup and view all the answers

    Which type of testicular tumor is rare in adults and has a good prognosis in children?

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

    Which type of testicular tumor is rare, fast-growing, and tends to spread rapidly?

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

    Which germ layers do testicular tumors derive from?

    <p>Endoderm, mesoderm, ectoderm</p> Signup and view all the answers

    What is the primary management approach for testicular tumors?

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

    What is the characteristic clinical presentation of testicular tumors?

    <p>Painless swelling or nodule in the testis</p> Signup and view all the answers

    What is the most common solid malignant tumor in men aged 30 to 34 years?

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

    Which factor significantly increases the risk of testicular cancer?

    <p>Having a first-degree relative with testicular cancer</p> Signup and view all the answers

    What is the primary cause of torsion, a urological emergency?

    <p>Twisting of the testicular venous drainage</p> Signup and view all the answers

    Which genetic abnormality increases the risk of developing testicular cancer?

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

    What is the most common cause of testicular cancer in men aged 30 to 30 years?

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

    What is the primary management approach for preventing the risk of torsion in the contralateral testis?

    <p>Fixation of the affected testis</p> Signup and view all the answers

    Study Notes

    Testicular Infections, Torsion, and Cancer Overview

    • Acute epididymo-orchitis presents with pain and swollen epididymis, caused by inflammation and neutrophil predominance
    • Management involves culture and sensitivity testing, raised C-Reactive Protein, ultrasound scans, and treatment with antibiotics, pain relief, and scrotal elevation
    • Chronic cases may require inpatient care and can lead to scarring and sterility
    • Torsion is a urological emergency resulting from twisting of the spermatic cord, leading to testicular infarction
    • Torsion presents with sudden testicular pain and must be "untwisted" within 6 hours to preserve testis viability
    • Testicular cancer is the most common solid malignant tumor in men aged 30-34, with a higher incidence in Caucasian men
    • Causes of testicular cancer include cryptorchidism, previous testicular cancer, genetic abnormalities, family history, infertility, and exposure to estrogen
    • Germ cell tumors, including seminomatous and non-seminomatous types, account for over 90% of testicular cancers
    • Seminomas grow slowly and are classified into classical and spermatocytic subtypes, affecting different age groups
    • Non-seminomatous germ cell tumors typically occur in men in their late teens and early 30s and include embryonal carcinoma, yolk sac tumor, choriocarcinoma, and teratoma
    • Each type of non-seminomatous germ cell tumor has distinct characteristics, growth patterns, and prognosis
    • Teratomas, derived from 3 germ cell layers, can be mature or immature, with varying potential for spreading and recurrence

    Pathological Conditions of the Testes and Testicular Cancer

    • A 41-year-old man's testes showed severe inflammation due to complications of enterocolitis and abscess formation, leading to testis removal.
    • Torsion, a urological emergency, results from twisting of the testicular venous drainage and causes sudden testicular pain.
    • Delayed treatment of torsion can lead to testicular infection and necrosis, requiring surgical intervention within 6 hours for viability.
    • Torsion management includes fixation of the affected testis and preventive measures for the contralateral testis to reduce the risk of torsion.
    • A 74-year-old man experienced testicular pain following drainage of a hydrocele, a collection of fluids around the testes, leading to a differential diagnosis of epididymitis.
    • Antibiotic treatment for the 74-year-old man's condition failed, and subsequent examination revealed a necrotic testis with hemorrhagic appearance and infiltrates.
    • Testicular cancer is the most common solid malignant tumor in men aged 30 to 30 years, with a higher incidence in Caucasian men than in black men.
    • Testicular cancer accounts for less than 1% of new cancers in the UK, with a 28% increase in incidence since the early 1990s.
    • Causes of testicular cancer include patient-related factors such as cryptorchidism, previous testicular cancer history, and genetic abnormalities like Klinefelter syndrome and Down's syndrome.
    • Patients with cryptorchidism and intra-abdominal testes have a significantly higher risk of testicular cancer compared to those with normal testicular anatomy.
    • Environmental factors play a minimal role in the development of testicular cancer, with patient-related factors being the primary contributors.
    • Genetic abnormalities, such as Klinefelter syndrome and Down's syndrome, increase the risk of developing testicular cancer.

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    Related Documents

    L4 (T3) Pathology of the Testis.pptx

    Description

    Test your knowledge of testicular infections, torsion, and cancer with this overview quiz. Explore key points such as symptoms, management, and risk factors for conditions like epididymo-orchitis, testicular torsion, and various types of testicular cancer.

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