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Questions and Answers
What are the two main components inside the testis?
What are the two main components inside the testis?
The two main components inside the testis are the stromal component and the parenchymal component.
Give one of the functions of Sertoli cells.
Give one of the functions of Sertoli cells.
Sertoli cells help in the maturation of spermatogonia into spermatozoa.
What is the most prevalent type of testicular tumor?
What is the most prevalent type of testicular tumor?
- Germ cell tumor (correct)
- Sex-cord stromal tumor
- Lymphoma
- None of the above
Testicular tumors are more common in older men than in younger men.
Testicular tumors are more common in older men than in younger men.
Which of these is not a risk factor for testicular germ cell tumors?
Which of these is not a risk factor for testicular germ cell tumors?
What is the primary function of the yolk sac?
What is the primary function of the yolk sac?
What is the term for the membranous structure that develops during early embryogenesis and plays a crucial role in the nutrition and development of the embryo?
What is the term for the membranous structure that develops during early embryogenesis and plays a crucial role in the nutrition and development of the embryo?
What is the name of the specialized organ that forms later in pregnancy to facilitate the exchange of oxygen, nutrients, and waste products between the mother and the fetus?
What is the name of the specialized organ that forms later in pregnancy to facilitate the exchange of oxygen, nutrients, and waste products between the mother and the fetus?
Which of the following is a type of germ cell tumor that is derived from germ cell neoplasia in siu (GCNIS)?
Which of the following is a type of germ cell tumor that is derived from germ cell neoplasia in siu (GCNIS)?
What is the most common type of germ cell tumor?
What is the most common type of germ cell tumor?
Teratomas are always benign.
Teratomas are always benign.
What is the most common type of mixed germ cell tumor?
What is the most common type of mixed germ cell tumor?
What does the letter "S" stand for in the staging system for testicular cancer?
What does the letter "S" stand for in the staging system for testicular cancer?
The staging of testicular cancer is determined by the size of the tumor.
The staging of testicular cancer is determined by the size of the tumor.
Which type of germ cell tumor is most aggressive?
Which type of germ cell tumor is most aggressive?
What is the name of the syndrome that is characterized by multi-organ hemorrhagic metastases and is associated with choriocarcinoma?
What is the name of the syndrome that is characterized by multi-organ hemorrhagic metastases and is associated with choriocarcinoma?
What is the most common type of sex cord stromal tumor?
What is the most common type of sex cord stromal tumor?
Leydig cell tumors are more common in children than in adults.
Leydig cell tumors are more common in children than in adults.
What is the name of the diagnostic feature of Leydig cell tumors?
What is the name of the diagnostic feature of Leydig cell tumors?
Which of the following is a sign or symptom that is not typically associated with a Leydig cell tumor?
Which of the following is a sign or symptom that is not typically associated with a Leydig cell tumor?
What is the most likely diagnosis for a 28-year-old man who presents with a testicular mass, elevated serum levels of chorionic gonadotropin and alpha-fetoprotein, and enlarged para-aortic lymph nodes?
What is the most likely diagnosis for a 28-year-old man who presents with a testicular mass, elevated serum levels of chorionic gonadotropin and alpha-fetoprotein, and enlarged para-aortic lymph nodes?
Which of the following is the most likely diagnosis for a 37-year-old man who presents with bilateral breast enlargement, a firm right testis, and a brown cut surface on the testicular mass that is microscopic appearance?
Which of the following is the most likely diagnosis for a 37-year-old man who presents with bilateral breast enlargement, a firm right testis, and a brown cut surface on the testicular mass that is microscopic appearance?
A 30-year-old man presents with a testicular mass. Which of the following would be the most likely diagnosis if the serum LDH is the only abnormality that is elevated?
A 30-year-old man presents with a testicular mass. Which of the following would be the most likely diagnosis if the serum LDH is the only abnormality that is elevated?
Seminomas are more common in prepubertal boys than in adults.
Seminomas are more common in prepubertal boys than in adults.
A pathologist is examining a testicular tumor. What is the most likely diagnosis if the tumor is composed of large, abnormal nucleated cells, and spermatogenesis is not present?
A pathologist is examining a testicular tumor. What is the most likely diagnosis if the tumor is composed of large, abnormal nucleated cells, and spermatogenesis is not present?
If a patient has germ cell neoplasia in situ, it is guaranteed that they will develop invasive tumors at some point.
If a patient has germ cell neoplasia in situ, it is guaranteed that they will develop invasive tumors at some point.
Which of the following is a characteristic found in the microscopic appearance of a teratoma?
Which of the following is a characteristic found in the microscopic appearance of a teratoma?
Which of the following germ cell tumors is known to be usually associated with a high AFP serum level?
Which of the following germ cell tumors is known to be usually associated with a high AFP serum level?
What is the term used for the abnormal cells that are present in a tumor that has malignant transformations within the teratoma?
What is the term used for the abnormal cells that are present in a tumor that has malignant transformations within the teratoma?
Which of the following statements about spermatocytic tumors is correct?
Which of the following statements about spermatocytic tumors is correct?
What major symptom is often associated with testicular tumors?
What major symptom is often associated with testicular tumors?
The tunica vaginalis consists of both visceral and parietal layers.
The tunica vaginalis consists of both visceral and parietal layers.
What type of testicular tumor makes up about 95% of testicular tumors?
What type of testicular tumor makes up about 95% of testicular tumors?
The main cell type in the stromal component of the testis is called __________.
The main cell type in the stromal component of the testis is called __________.
Which of the following statements about the incidence of testicular tumors is correct?
Which of the following statements about the incidence of testicular tumors is correct?
Match the following testicular structures or components with their functions:
Match the following testicular structures or components with their functions:
Stromal tumors are more common than germ cell tumors.
Stromal tumors are more common than germ cell tumors.
What is the primary role of Sertoli cells in the testis?
What is the primary role of Sertoli cells in the testis?
Which immunological markers are seminomas reactive to?
Which immunological markers are seminomas reactive to?
Embryonal carcinomas are immunoreactive to both OCT4 and c-KIT.
Embryonal carcinomas are immunoreactive to both OCT4 and c-KIT.
What is the specific immunohistochemical serological marker for seminoma?
What is the specific immunohistochemical serological marker for seminoma?
Choriocarcinoma (CC) produces ___.
Choriocarcinoma (CC) produces ___.
Match the tumor type to their tissue marker:
Match the tumor type to their tissue marker:
Which of the following describes the gross appearance of a seminoma?
Which of the following describes the gross appearance of a seminoma?
Genetic predisposition is a risk factor linked to carcinogenic outcomes in germ cell tumors.
Genetic predisposition is a risk factor linked to carcinogenic outcomes in germ cell tumors.
What does GCNIS stand for?
What does GCNIS stand for?
What peak age range is associated with non-seminomatous tumors?
What peak age range is associated with non-seminomatous tumors?
Yolk sac tumors resemble placental cells.
Yolk sac tumors resemble placental cells.
Name one risk factor for germ cell tumors.
Name one risk factor for germ cell tumors.
Germ cell tumors are primarily classified based on their origin as GCNIS-related tumors and _______ tumors.
Germ cell tumors are primarily classified based on their origin as GCNIS-related tumors and _______ tumors.
Which of the following types of germ cell tumors is not derived from germ cell neoplasia in situ?
Which of the following types of germ cell tumors is not derived from germ cell neoplasia in situ?
Match the following germ cell tumors with their characteristics:
Match the following germ cell tumors with their characteristics:
Family history is a recognized risk factor for germ cell tumors.
Family history is a recognized risk factor for germ cell tumors.
What is the primary function of the placenta during pregnancy?
What is the primary function of the placenta during pregnancy?
What is the most likely diagnosis for a 37-year-old man who has noticed bilateral breast enlargement, a firm right testis, and a brown cut surface on the testicular mass with rod-shaped crystalloids of Reinke?
What is the most likely diagnosis for a 37-year-old man who has noticed bilateral breast enlargement, a firm right testis, and a brown cut surface on the testicular mass with rod-shaped crystalloids of Reinke?
Bilateral involvement of testicular tumors occurs in 3% of cases.
Bilateral involvement of testicular tumors occurs in 3% of cases.
Which tumor type is most often associated with elevated serum LDH?
Which tumor type is most often associated with elevated serum LDH?
What does the 'S' stand for in the staging system for testicular cancer?
What does the 'S' stand for in the staging system for testicular cancer?
Reinke crystals are diagnostic of __________ cells.
Reinke crystals are diagnostic of __________ cells.
Choriocarcinoma is commonly found as a pure tumor.
Choriocarcinoma is commonly found as a pure tumor.
Match the following conditions with their associated characteristics:
Match the following conditions with their associated characteristics:
What high serum level is associated with Yolk Sac Tumors?
What high serum level is associated with Yolk Sac Tumors?
The microscopic appearance of embryonal carcinoma features large cells with a prominent __________.
The microscopic appearance of embryonal carcinoma features large cells with a prominent __________.
Match each tumor type with its associated characteristic:
Match each tumor type with its associated characteristic:
Which of the following is a defining feature of prepubertal teratomas?
Which of the following is a defining feature of prepubertal teratomas?
Seminomas can be identified by specific serum markers.
Seminomas can be identified by specific serum markers.
What is the primary appearance seen in postpubertal yolk sac tumors under a microscope?
What is the primary appearance seen in postpubertal yolk sac tumors under a microscope?
What characterizes a teratoma with somatic type malignancy?
What characterizes a teratoma with somatic type malignancy?
Teratomas are highly responsive to chemotherapy.
Teratomas are highly responsive to chemotherapy.
What are the common combinations seen in mixed germ cell tumors?
What are the common combinations seen in mixed germ cell tumors?
A ______ tumor is clinincally benign and often appears in older age groups, with a distinct absence of GCNIS.
A ______ tumor is clinincally benign and often appears in older age groups, with a distinct absence of GCNIS.
Which of the following best describes the appearance of a teratoma?
Which of the following best describes the appearance of a teratoma?
Match the following types of tumors with their characteristics:
Match the following types of tumors with their characteristics:
Spermatocytic tumors can metastasize and are highly aggressive.
Spermatocytic tumors can metastasize and are highly aggressive.
In which age group does a spermatocytic tumor most commonly occur?
In which age group does a spermatocytic tumor most commonly occur?
Flashcards
Tunica albuginea
Tunica albuginea
The outermost layer of the testis, composed of dense connective tissue.
Tunica vaginalis
Tunica vaginalis
The serous membrane covering the testis. It has visceral and parietal components.
Stromal component
Stromal component
The supportive framework of the testis, containing Leydig cells and connective tissue.
Parenchymal component
Parenchymal component
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Sertoli cells
Sertoli cells
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Spermatogonia
Spermatogonia
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Testicular cancer
Testicular cancer
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Germ cell tumor
Germ cell tumor
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Palpable mass
Palpable mass
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Cryptorchidism
Cryptorchidism
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Gonadal dysgenesis
Gonadal dysgenesis
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Yolk sac
Yolk sac
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Germ cell neoplasia in situ (GCNIS)
Germ cell neoplasia in situ (GCNIS)
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Teratoma
Teratoma
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Embryonal carcinoma
Embryonal carcinoma
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Yolk sac tumor (YST)
Yolk sac tumor (YST)
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Choriocarcinoma (CC)
Choriocarcinoma (CC)
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Alpha-fetoprotein (AFP)
Alpha-fetoprotein (AFP)
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Human chorionic gonadotropin (HCG)
Human chorionic gonadotropin (HCG)
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Lactate dehydrogenase (LDH)
Lactate dehydrogenase (LDH)
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Seminoma
Seminoma
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Embryonal carcinoma
Embryonal carcinoma
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Yolk sac tumor
Yolk sac tumor
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Choriocarcinoma
Choriocarcinoma
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Teratoma
Teratoma
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Spermatocytic tumor
Spermatocytic tumor
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Leydig cell tumor
Leydig cell tumor
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Staging System
Staging System
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pT2
pT2
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Reinke Crystals
Reinke Crystals
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Testicular Cancer Staging System
Testicular Cancer Staging System
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Serum marker concentration
Serum marker concentration
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Non-seminomatous tumors
Non-seminomatous tumors
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Germ cell neoplasia in situ (GCNIS-related tumor)
Germ cell neoplasia in situ (GCNIS-related tumor)
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Unrelated to germ cell neoplasia in situ (non-GCNIS-related tumor)
Unrelated to germ cell neoplasia in situ (non-GCNIS-related tumor)
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Seminoma with Syncytiotrophoblastic Elements
Seminoma with Syncytiotrophoblastic Elements
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Elevated Serum LDH
Elevated Serum LDH
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Yolk Sac Tumor: Microscopic Appearance
Yolk Sac Tumor: Microscopic Appearance
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Embryonal Carcinoma: Gross Appearance
Embryonal Carcinoma: Gross Appearance
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Postpubertal Teratoma
Postpubertal Teratoma
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Teratoma with Somatic Type Malignancy
Teratoma with Somatic Type Malignancy
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Mixed Germ Cell Tumor
Mixed Germ Cell Tumor
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Nonseminomatous Germ Cell Tumor
Nonseminomatous Germ Cell Tumor
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Non-GCNIS Related Tumors
Non-GCNIS Related Tumors
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OCT4 and c-KIT: Molecular Markers in Testicular Cancer
OCT4 and c-KIT: Molecular Markers in Testicular Cancer
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OCT4 and c-KIT Suppression in Germ Cell Development
OCT4 and c-KIT Suppression in Germ Cell Development
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12p Gain and Totipotency
12p Gain and Totipotency
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GCNIS: Precursor to Invasivie Testicular Cancer
GCNIS: Precursor to Invasivie Testicular Cancer
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Hormonal Markers: CC, YST, and Seminomas
Hormonal Markers: CC, YST, and Seminomas
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Risk Factor: Gonadal Dysgenesis
Risk Factor: Gonadal Dysgenesis
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Seminoma: Common Testicular Cancer
Seminoma: Common Testicular Cancer
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Seminoma: Gross and Microscopic Appearance
Seminoma: Gross and Microscopic Appearance
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Study Notes
Testis Tumors - Gross Anatomy
- The testis is the male gonad, composed of tubules.
- The testis is enclosed by the tunica albuginea, a fibrous layer.
- The peritoneum, with parietal and visceral layers (tunica vaginalis), surrounds the testis.
- During embryonic development, the gonads move outside the peritoneum through the retroperitoneum and inguinal canal.
- The tunica albuginea's integrity is crucial for proper staging if a tumor develops.
- The testicular stroma, responsible for structure and hormone production, is mainly made up of Leydig cells. Stromal tumors are rare compared to germ cell tumors.
- Germ cell tumors are far more prevalent than stromal tumors.
- Grossly, a whitish appearance with clear demarcation and a somewhat nodular appearance, bulging outward is often seen.
Testicular Tumors: Prevalence
- Testicular tumors are rare, accounting for approximately 1% of all male cancers.
- They most commonly occur between puberty and young adulthood.
- Germ cell tumors make up the vast majority (95%).
- The most frequent symptoms include a palpable mass, metastasis, blood in semen, and pain.
- Chemotherapy is highly effective, and mortality rates have decreased.
Germ Cell Tumors
- Two main categories: seminomas and non-seminoma tumors.
- Seminomas peak during adulthood, while non-seminoma tumors peak during adolescence.
- Risk factors include cryptorchidism, prior testicular tumors, family history (first-degree male relatives), gonadal dysgenesis with a Y chromosome, and androgen insensitivity syndrome.
Germ Cell Tumor Classification
- Based on origin: Derived from germ cell neoplasia in situ (GCNIS) or unrelated to it.
- Based on morphology: Seminoma, Teratoma (resembling somatic cells), Embryonal Carcinoma (resembling embryonic stem cells), Yolk sac tumor (resembling yolk sac cells), and Choriocarcinoma (resembling placental cells).
Physiological Role of OCT4 and c-KIT
- Immunohistochemistry uses OCT4 (in the nucleus) and c-KIT (on cellular membranes) to distinguish GCNIS and non-GCNIS tumors.
- These markers are crucial for differentiating seminomas and embryonal carcinomas.
Yolk Sac Tumor
- Important in early embryonic development, aiding in blood cell and vessel formation, primordial germ cell formation, and the initial nutrition of the embryo.
- Associated with high AFP levels.
- Frequently pure in prepubertal patients and usually part of a mixed tumor in adults.
Choriocarcinoma
- A rare but aggressive tumor with a high serum HCG count.
- Often metastatic, often presenting first with metastasis.
Seminoma
- The most common type of germ cell tumor in a pure form.
- Associated with elevated serum LDH.
- Frequently presents in younger adults.
- Often characterized by a mass.
Embryonal Carcinoma
- Often presented as part of a mixed tumor.
- Characterized by prominent nucleus, overlapping nuclei, and a high-grade neoplasm morphology, appearing as a large cell mass.
Mixed Germ Cell Tumors
- Common combinations include embryonal carcinoma with teratoma, embryonal carcinoma with seminoma, and combinations involving yolk sac tumor.
Sex Cord-Stromal Tumors
- Account for a small percentage (5%) of testicular tumors.
- Leydig cell tumors are the most common type, often presenting with yellow masses resembling adrenal glands in gross appearance.
- Histologically distinguished by distinctive cells with Reinke crystals.
Staging
- Prognosis of testicular tumors is not determined by size, but rather by the extent to which nearby structures are invaded.
- Staging factors include tumor size, lymph node involvement, and distant metastasis as assessed by serum tumor markers (e.g. LDH, AFP and hCG), with higher markers correlating to more advanced disease.
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Description
Explore the key aspects of testis tumors including their gross anatomy and prevalence among male cancers. This quiz covers the structure of the testis, embryonic development, and the types of tumors, focusing predominantly on germ cell tumors. Test your knowledge on the critical details of testicular anatomy and the statistics surrounding testicular tumors.
