My Wiki
  • Introduction
  • 01 Step 1
    • Antimicrobials
      • 01 Cell Wall And Membrane
      • 02 Protein Synthesis
      • 03 Others
      • 04 Antimicrobials
    • Behavior Science
      • Development
      • Public Health Copy
      • Public Health
    • Biochemistry
      • 01 DNA Structure
      • 02 Purine
      • 03 Pyrimidine
      • 04 Glucose
      • 05 Glycolysis
      • 06 Gluconeogenesis
      • 07 Glycogen
      • 08 HMP Shunt
      • 09 Fructose And Galactose
      • 10 Pyruvate Dehydrogenase
      • 11 TCA
      • 12 ETC
      • 13 FA
      • 14 Ketones
      • 15 Ethanol
      • 17 Inborn Errors
      • Ammonia
      • B Vitamins
      • Lysosomal Storage Diseases
      • Other Vitamins
    • Cardiology
      • 01 Cardiac Anatomy
      • 01 Cardiac Embryology
      • 02 Heart Physiology
      • 03 Congenital Heart Disease
      • 04 Cardiac Cycle
      • 06 PV Loop
      • 07 Wiggers And Venous
      • 09 Starling
      • 10 Cardiac Ischemia
      • 11 Stable Angina
      • 14 EKG Basics
      • 15 EKG Others
      • 15 High Yield EKG
      • 16 Cardiac AP
      • 17 BBB
      • 21 Antiarrhythmics
      • 22 Heart Murmurs
      • 23 Heart Sounds
      • 24 HF Basics
      • 25 Systolic Diastolic HF
      • 26 Restrictive Cardiomyopathy
      • 27 Acute HF
      • 28 Chronic HF
      • 30 Shunts
      • 31 Congenital Heart Disease
      • 32 Hypertension
      • 33 Antihypertensives
      • 34 Valvular Disease
      • 35 Shock
      • 36 Pericardial Disease
      • 37 Aortic Dissection
      • 38 Cardiac Tumors
      • 39 Hypertrophic Cardiomyopathy
      • 40 Endocarditis
      • Chest Pain
    • Cell
      • 01 DNA
      • 02 DNA Mutation
      • 03 DNA Repair
      • 04 Transcription
      • 05 Translation
      • 06 PCR
      • Cell Cycle
      • Cell Structure
      • CT
      • Cytoskeleton
    • Endocrinology
      • 01 Thyroid
      • 02 Thyroid Disorders
      • 03 Adrenal Gland
      • 04 Adrenal Disorders
      • 05 CAH
      • 06 Pituitary Anatomy
      • 07 Pituitary Secretions
      • 08 Pituitary Pathology
      • 10 Endocrine Pancreas
      • 11 Diabetes
      • 12 Diabetes Treatment
      • 13 Insulin
      • 14 Parathyroid
      • 15 MEN
    • Genetics
      • 01 Genetic Principles
      • 02 Gene Mapping
      • 03 Meiosis
      • 04 Hardy
      • 05 Pedigree
      • 06 Imprinting
      • 07 Down
      • 08 Trisomy
      • 09 AD
      • Deletion
      • Trinucleotide Disorders
    • GI
      • 01 Embryology
      • 02 GI Anatomy
      • 03 GI Blood
      • 04 GI Tract
      • 05 Liver Gallbladder Pancreas
      • 06 Salivary
      • 07 Hernia
      • 08 Bile
      • 09 Bilirubin
      • 10 GI Secretion
      • 11 GI Hormones
      • 12 Exocrine Pancreas
      • 13 Esophageal Disorders
      • 14 Liver Disease
      • 15 Cirrhosis
      • 16 Liver Tumors
      • [17 Wilson S](01 Step 1/GI/17 Wilson's.md)
      • 18 Gallstones
      • 19 Biliary Disorders
      • 20 Gastric
      • 21 Malabsorption
      • 22 Acute Pancreatitis
      • 23 Chronic Pancreatitis
      • 24 Intestinal Disorders
      • 25 IBD
      • 26 Colon Cancer
    • Heme
      • 01 Coagulation
      • 02 Platelets
      • 03 Hypercoagulable States
      • 04 Coagulopathies
      • 05 Platelet Disorders
      • 06 Antiplatelet
      • 08 Hemolysis Basics
      • 09 Extrinsic Hemolysis
      • 10 Intrinsic Hemolysis
      • 11 Microcytic Anemia
      • 12 Thalassemia
      • 13 Sickle Cell
      • 14 Other Anemias
      • 15 Blood Groups
      • 16 Acute Leukemia
      • 17 Chronic Leukemia
      • 18 Hodgkin Lymphoma
      • 19 Nonhodgkin Lymphoma
      • 20 Plasma Cell Disorders
      • 21 Amyloidosis
      • 22 Myeloproliferative
      • 23 Porphyrias
    • Immunology
      • 01 Innate Immunity
      • 02 T Cells
      • 03 B Cells
      • 04 Complement
      • 05 Spleen
      • Antibodies
      • Glucocorticoids
      • Hypersensitivity
      • Immune Deficiencies
      • Immunosuppressants
      • Lupus
      • Rheumatoid Arthritis
      • Scleroderma
      • Sjogren
      • Transplants
      • Vasculitis
    • Infectious Disease
      • 01 Bacteria
      • 02 Bacteria Culture
      • 03 Bacteria Virulence
      • 04 Virus Structure
      • 05 Bacterial Genetics
      • Malaria
      • Virus Sturcture
    • Microbes
      • 01 Gm Positive Cocci
      • 02 Gm Positive Bacilli
      • 03 Gm Negative Cocci
      • 04 Gm Negative Enteric Bacilli
      • 05 Gm Negative Respiratory Bacilli
      • 06 Gm Negative Zoonotic Bacilli
      • 07 Mycobacterium
      • 08 Spirochetes
      • 09 Gm Indeterminate
      • 10 Parasites
      • 11 Virus
      • Fungi
      • Herpes
      • Sketchy
      • Strep
    • MSK
      • 01 Bone Disorders
      • 01 Knee
      • 02 Shoulder
      • 03 Brachial
      • 04 Wrist
      • 05 Hand
      • 06 Lumbosacral
      • 07 Hip
      • 08 Bone Biology
      • 09 Skeletal Muscles
      • Dermatomes
    • Neurology
      • 01 CNS Cells
      • 02 Wallerian Degeneration
      • 03 BBB
      • 04 Neurotransmitters
      • 06 Cerebral Cortex
      • 07 Spinal Cord
      • 08 Spinal Cord Syndromes
      • 09 Brainstem
      • 10 Cranial Nerves
      • 11 Auditory System
      • 12 Vestibular System
      • 13 Thalamus
      • 14 Cerebellum
      • 15 Basal Ganglia
      • 16 Ventricles And Sinuses
      • 17 Cerebral And Lacunar Strokes
      • 18 Vertebrobasilar Stroke
      • 19 CNS Aneurysm
      • 20 Intracranial Bleeding
      • 21 Management Of Stroke
      • 25 Pupil
      • 26 Lens
      • 27 Retina
      • 30 Gaze Palsies
      • 31 Structural Eye Disorders
      • 32 Glaucoma
      • 36 Meningitis
      • 37 Seizures
      • 39 Dementia And Delirium
      • 40 Demyelinating Diseases
      • 41 Headaches
      • 42 Brain Tumors
      • 43 Movement Disorders
      • 44 CNS Infections
    • Pharm
      • 01 Autonomics
      • 02 Cardiorenal
      • 03 Blood
      • 04 Smooth Muscles
      • 05 GI
      • Analgesics
      • Antineoplastics
      • Cholinometics
      • CYP 450
      • Parkinson
      • Psych
      • Sedatives
    • Pharmacology
      • 01 Enzymes
      • 02 Inhibitors
      • 03 Dose
      • 04 Drug Elimination
      • 05 Pharmacokinetics
    • Pulmonary
      • 01 Pulmonary Anatomy
      • 02 Pulmonary Physiology
      • 03 Hemoglobin
      • 04 Pulmonary Circulation
      • 05 Hypoxia
      • 06 Ventilation
      • 07 CO 2
      • 08 Pulmonary Exam
      • 09 PFT
      • 10 Obstructive
      • 11 Restrictive
      • 12 COPD Treatment
      • 13 Pneumonia
      • 14 Pleural Disease
      • 15 Lung Cancer
      • 16 Sleep Apnea
      • 17 Cystic Fibrosis
      • 18 TB
      • 19 Sarcoidosis
      • 20 PE
      • 21 Xray
    • Renal
      • 01 Renal Embryology
      • 02 Renal Anatomy
      • 03 Renal Physiology 1
      • 04 Renal Physiology II
      • 05 Nephron Physiology
      • 06 Renal Endocrine
      • 07 Acid Excretion
      • 08 Acid Base Principles
      • 09 Respiratory Disorders
      • 10 Metabolic Disorders
      • 11 RTA
      • 12 Metabolic Acidosis
      • 13 Electrolytes
      • 14 Na And Water
      • 15 Na Disorders
      • 16 Glomerulonephritis Principles
      • 17 Nephritic Syndrome
      • 18 Nephrotic Syndrome
      • 19 MPGN
      • 20 Tubulointerstitial Disease
      • 21 Renal Failure
      • 22 UTI
      • 23 Cystic Kidney
      • 24 Diuretics
      • 25 Renal Stones
      • 26 Renal Tumors
      • 27 Rhabdomyolysis
      • 28 Pathogenesis
    • Reproductive
      • Breast Disorders
      • Breast
      • Candida Albicans
      • Chlamydia Trachomatis
      • Disorders Of Sexual Differentiation
      • Female Pathology
      • Female Reproductive Embryology And Anatomy
      • Gardnerella Vaginalis
      • HPV
      • Male Anatomy
      • Male Pathology
      • Neoplastic Ovarian Pathology
      • Ovarian Pathology
      • Pharyngeal Arches
      • Preeclampsia
      • Testicular Pathology
      • Treponema Pallidu
      • Trichomonas Vaginalis
    • Uworld
      • Uworld Notes 2
      • Uworld Notes 3
      • Uworld Notes
  • 02 Step 2
    • Family
      • A Complicated Pregnancy
      • A Healthy Pregnancy
      • AAFP Questions
      • Derm
      • Family Planning
      • Labor
      • Postpartum Complications
      • Reproductive Endocrinology
    • Internal
      • 01 Cardiology
      • 01 EKG
      • 02 Pulmonary
      • 02 Pulmonary 2
      • 03 Pediatric
      • 04 Dermatology
      • 05 Endocrine
      • 06 GI
      • 07 Heme
      • 07 Heme 2
      • 08 Infectious Disease
      • 09 Fluid
      • 09 Nephrology
      • 09 Nephrology 2
      • 10 Ortho
      • 11 Cardiac Arrest
      • Exam
      • Uworld 2
      • Uworld
    • Neuro
      • Alpha Synuclens
      • Anatomy
      • Back Pain
      • Brain
      • CNS Infections
      • Coma
      • Dementia And Movement
      • Dementia
      • Dizziness
      • Eye Problems
      • Headache
      • Localization
      • Malignancies
      • Neuro Exam
      • Neuromuscular
      • Neuropathy
      • Others
      • Overview
      • Seizures Notes
      • Seizures
      • Spinal Cord Syndromes
      • Stroke Meded
      • Stroke
      • Tremors
      • Uworld Neuro Notes
    • OB
      • 01 Abnormal Pap
      • 01 Cancer
      • OB Cases
      • OB Uworld
    • Pediatrics
      • 01 Newborn Management
      • 02 NICU
      • 03 Failure To Pass Meconium
      • 04 Emesis
      • 05 Neonatal Jaundice
      • 06 Congenital Defect
      • Well Child
      • Vaccines
      • 09 SIDS
      • 10 Trauma
      • 11 Child Abuse
      • 12 Rashes
      • 13 Peds ID
      • 14 Allergies
      • 15 ENT
      • 16 Upper Airway
      • 17 Lower Airway
      • 18 Seizures
      • 19 GI Bleed
      • 20 CT Surgery
      • 21 Orthopedics
      • 22 Ophthalmology
      • Pediatric Nephrology
      • Pediatric Sickle Cell
      • 25 Immunodeficiency
      • Ambulatory
      • Genetic Syndromes
      • Misc
      • Neonatal Rashes
      • Newborn Nursery
      • Pretest Adolescent
      • Pretest Cardiorespiratory
      • Pretest Endocrine
      • Pretest GI
      • Pretest Infectious Disease
      • Pretest Neuro
      • Pretest Newborn
      • Pretest
      • PTT Vs Anti Xa
      • Uworld
      • Wards
    • Psych
      • Anxiety Disorders
      • Childhood Psychiatry
      • Dementia Delirium
      • Dissociative Disorders
      • Eating Disorders
      • EEG
      • Factitious Disorders
      • Impuse Control
      • Legal Psychiatry
      • Mood Disorders
      • Nonpharm Treatment
      • Personality Disorders
      • Psychiatric Exams
      • Psychopharmacology
      • Psychosis Ddx
      • Psychotic Disorders
      • Sexual Disorders
      • Sleep Disorders
      • Substance Abuse
      • Uworld Psych
      • Week 2
    • Surgery
      • 01 Ethics
      • 01 Trauma
      • 02 Colorectal
      • 02 Pediatric
      • 03 Burns
      • 03 Gyn
      • 04 Postoperative
      • 05 Preoperative
      • 06 Trauma
      • 07 Burns
      • 08 Cardiology
      • 09 Colorectal
      • 10 Dermatology
      • 11 Endocrine
      • 12 ENT
      • 13 ER
      • 14 General Surgery
      • 15 GI
      • 17 Infectious Disease
      • 18 Nephrology
      • 19 Neuroendocrine Tumors
      • 20 Orthopedics
      • 21 Pulmonary
      • 22 Shock
      • 23 Transplant
      • 24 Urology
      • 25 Breasts
      • 25 Vascular
      • Fluids
      • GI Autonomics
      • Notes
      • Review
    • Uworld
      • Class Notes
      • Step 2 Uworld 1
      • Uworld 2
      • Uworld 3
      • Uworld 4
      • Uworld 5
  • 03 Residency
    • 01 Insulin
    • 02 ICU
    • 03 Electrolytes
    • 04 Sedation
    • 05 Wards
    • 06 Acid Base
    • Orientation Notes
    • Prescription Writing
Powered by GitBook
On this page
  • Germ Cell Tumors
  • Seminoma
  • Embryonal Carcinoma
  • Choriocarcinoma
  • Testicular Teratomas
  • Non Germ cell
  • Leydig cell tumor
  • Sertoli Cell Tumor
  • Testicular Lymphoma
  • Diffuse large B cell Non-Hodgkin

Was this helpful?

  1. 01 Step 1
  2. Reproductive

Testicular Pathology

PreviousPreeclampsiaNextTreponema Pallidu

Last updated 5 years ago

Was this helpful?

Germ Cell Tumors

Most common type of testicular tumor (>95% of cases), and they usually occur between 15-40 years of age.,

Patients will often present with a firm testicular mass that cannot be transilluminated., (hypoechoic)

Can be classified as one of the following types:

  • Seminoma (55% of cases) are highly responsive to radiotherapy, metastasize late, and have an excellent prognosis.

  • Nonseminomas (45% of cases) show variable response to treatment and often metastasize early

    • Yolk sac tumors

    • Embryonal carcinoma and teratoma

    • Choriocarcinoma.,

Tumor markers:

  • Yolk sac: high AFP

  • Choriocarcinoma: high b-HCG

  • embryonal, teratoma: high AFP or b-HCG

  • seminoma: high ALP and rarely HCG..

The risk factors for germ cell tumors of the testicle include the following:

  • Cryptorchidism (most common)

  • Androgen Insensitivity

  • Family history of testicular cancer

  • Down Syndrome

  • Klinefelter syndrome.,

Seminoma

Testicular ultrasound showing a hypoechoic intratesticular mass.

lymphocytic infiltrate:

Embryonal Carcinoma

Gross appearance is a pale grey, bulky, hemorrhagic and necrotic tumor.

  • Palpable testicular mass

  • Painful., (Note: this is different from other testicular tumors, which are usually painless)

Choriocarcinoma

The gross appearance is a small primary tumor with extensive necrosis and hemorrhage.

The alpha-subunit of beta-hCG is similar to the alpha-subunit of LH, FSH, and TSH. This can result in hyperthyroidism. The beta-subunit is the unique subunit to each hormone, and is responsible for the majority of their physiologic effects.,

Testicular Teratomas

Non Germ cell

Leydig cell tumor

Sertoli Cell Tumor

Testicular Lymphoma

Diffuse large B cell Non-Hodgkin

The diagnosis of testicular cancer is often made with ultrasound, which reveals a hypoechoic intratesticular mass..

The most common testicular tumor (40%) that originates in the germinal epithelium or the seminiferous tubules.,; resembles ovarian dysgerminoma.

On histology will reveal clear, polygonal germ cells with round nuclei and prominent nucleoli that are arranged into lobules and surrounded by septa. There is often a lymphocytic infiltrate and granulomas. Grossly these tumors appear as a bulky, gray tumor without hemorrhage or necrosis.,

Most commonly present with painless testicular enlargement.,

Highly radiosensitive and have an excellent prognosis with treatment. Later stage neoplasms often require surgical resection (orchidectomy)..

Rare malignant tumor comprised of immature, primitive cells that form papillary/glandular structures. Metastasis is commonly hematogenous.,

On histology will appear as sheets of undifferentiated cells with marked nuclear atypia, prominent nucleoli, and focal glandular differentiation or papillary morphology.,

Neoplastic cells displaying nuclear atypia, prominent nucleoli, and necrosis.

Are less radiosensitive than seminomas, and also more aggressive with an intermediate prognosis. Chemotherapy may result in differentiation into another type of germ cell tumor (e.g. teratoma).,

The clinical presentation includes the following:

Malignant tumor of syncytiotrophoblasts and cytotrophoblasts (placenta-like tissue, but villi are absent). It is the most aggressive testicular tumor; poor prognosis..

On histology reveal mixed proliferation of syncytiotrophoblasts (large multinucleated cells with eosinophilic cytoplasm that produce beta-hCG) and cytotrophoblasts (mononuclear cells with clear cytoplasm)..

Tumor marker used to monitor and/or confirm the diagnosis is an elevated hCG (human chorionic gonadotropin) in nearly 100% of cases. This may present as gynecomastia, because if you recall hCG has a similar alpha subunit as LH (↑ LH → breast development)

Commonly metastasize hematogenously, most commonly to the lungs (causing hemoptysis), brain (causing hemorrhagic stroke), and liver.,

In males are malignant (often squamous cell malignancy). This is important to remember, because the mature teratoma (dermoid cyst) in females is benign..

aka dermoid cyst.,

Resemble sex cord-stromal tissues of the testicle, and they are usually benign. The two most common types are Leydig cell and Sertoli cell tumors..

Benign tumor of Leydig cells that produces androgens and may also produce estrogens..

Patient presentation will depend on age; precocious puberty in children and gynecomastia in adult men.,

A characteristic finding on microscopy is intracytoplasmic Reinke crystals(rod-shaped crystals) within the neoplastic Leydig cells..

Benign tumor of Sertoli cells that is comprised of tubules. It most commonly does not produce hormones and therefore presents as a testicular mass..

Most common cause of testicular cancer found in males >60 years old. They are often bilateral, and arise due to metastasis.,

The most common testicular lymphoma subtype.,

_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_
_