Difference between revisions of "Testis"

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Testis (view source)

Revision as of 16:21, 9 September 2025

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→‎IHC for GCTs
 
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Image:Seminiferous_tubule_and_sperm_low_mag.jpg | Seminiferous tubule and sperm - low mag. (WC/Nephron)
Image:Seminiferous_tubule_and_sperm_low_mag.jpg | Seminiferous tubule and sperm - low mag. (WC/Nephron)
Image:Seminiferous_tubule_and_sperm.jpg | Seminiferous tubule and sperm - high mag. (WC/Nephron)
Image:Seminiferous_tubule_and_sperm.jpg | Seminiferous tubule and sperm - high mag. (WC/Nephron)
Image:Intratubular_germ_cell_neoplasia_-_2_-_very_high_mag.jpg | Benign seminiferous tubules and ITGCN. (WC/Nephron)
Image:Intratubular_germ_cell_neoplasia_-_2_-_very_high_mag.jpg | Benign seminiferous tubules and GCNIS (ITGCN). (WC/Nephron)
</gallery>
</gallery>
====Interstitial====
====Interstitial====
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Image:Leydig_cells_-_very_high_mag.jpg | Leydig cells - very high mag. (WC/Nephron)
Image:Leydig_cells_-_very_high_mag.jpg | Leydig cells - very high mag. (WC/Nephron)
</gallery>
</gallery>
====Associated structures====
*[[Epididymis]] - stores the sperm.
**Pseudostratified epithelium with cilia.
Image:
*[http://www.webpathology.com/image.asp?n=3&Case=27 Epididymis (webpathology.com)].


====Rete testis====
====Rete testis====
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www:
www:
*[http://www.webpathology.com/image.asp?case=27&n=5 Rete testis (webpathology.com)].
*[http://www.webpathology.com/image.asp?case=27&n=5 Rete testis (webpathology.com)].
====Associated structures====
====Epididymis====
{{main|Epididymis}}
*[[Epididymis]] - stores the sperm.
**Pseudostratified epithelium with [[cilia]].
Image:
<gallery>
Image:Epididymis_high_mag.jpg |[[Micrograph]] of an epididymis. [[H&E stain]].
</gallery>


====Appendix of testis====
====Appendix of testis====
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**[[Leydig cell tumour]].
**[[Leydig cell tumour]].
**[[Sertoli cell tumour]].
**[[Sertoli cell tumour]].
===Serum markers of testicular tumours===
*AFP (alpha-fetoprotein)
*hCG.
*LDH (lactate dehydrogenase).
*M371 (microRNA-371a-3p).<ref name=pmid37568759>{{cite journal |authors=Nestler T, Schoch J, Belge G, Dieckmann KP |title=MicroRNA-371a-3p-The Novel Serum Biomarker in Testicular Germ Cell Tumors |journal=Cancers (Basel) |volume=15 |issue=15 |pages= |date=August 2023 |pmid=37568759 |pmc=10417034 |doi=10.3390/cancers15153944 |url=}}</ref>


===IHC for GCTs===
===IHC for GCTs===
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*CD30 - embryonal carcinoma.
*CD30 - embryonal carcinoma.
*[[D2-40]] - seminoma.
*[[D2-40]] - seminoma.
*SALL4 - most [[germ cell tumour]]s.


===Tabular summary of GCTs===
===Tabular summary of GCTs===
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! Image
! Image
|-  
|-  
| [[Intratubular germ cell neoplasia]] (ITGCN)
| [[Germ cell neoplasia in situ]] (GCNIS)
| nests of small fried egg cells
| nests of small fried egg cells
| large central nucleus, clear <br>cytoplasm, round ''or'' polygonal nuclear membrane, [[nucleoli]]<ref name=Ref_GUP538>{{Ref GUP|538}}</ref>
| large central nucleus, clear <br>cytoplasm, round ''or'' polygonal nuclear membrane, [[nucleoli]]<ref name=Ref_GUP538>{{Ref GUP|538}}</ref>
| CD117
| CD117
| appearance similar to seminoma
| appearance similar to seminoma
| [[Image:Intratubular_germ_cell_neoplasia_high_mag_cropped.jpg|thumb|center|150px|ITGCN (WC)]]
| [[Image:Intratubular_germ_cell_neoplasia_high_mag_cropped.jpg|thumb|center|150px|GCNIS (WC)]]
|-  
|-  
| [[Seminoma]]
| [[Seminoma]]
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| [[Image:Teratoma_2_low_mag.jpg|thumb|center|150px|Teratoma (WC)]]
| [[Image:Teratoma_2_low_mag.jpg|thumb|center|150px|Teratoma (WC)]]
|-  
|-  
| [[Spermatocytic seminoma]]
| [[Spermatocytic tumour]] (previously ''spermatocytic seminoma'')
| population of 3 cells  
| population of 3 cells  
| pop.: (1) small cell with high [[NC ratio]] (mature lymphocyte-like), (2) medium with nucleoli, (3) large cells with filamentous chromatin - few present
| pop.: (1) small cell with high [[NC ratio]] (mature lymphocyte-like), (2) medium with nucleoli, (3) large cells with filamentous chromatin - few present
| ?
| ?
| does not arise from ITGCN, no lymphocytic infiltrate (like in seminoma)
| does not arise from GCNIS, no lymphocytic infiltrate (like in seminoma)
| [[Image:Spermatocytic_seminoma_high_mag.jpg|thumb|center|150px|Spermatocytic seminoma (WC)]]
| [[Image:Spermatocytic_seminoma_high_mag.jpg|thumb|center|150px|Spermatocytic tumour (WC)]]
|-  
|-  
| [[Mixed germ cell tumour]]
| [[Mixed germ cell tumour]]
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==Hydrocele testis==
==Hydrocele testis==
*[[AKA]] ''hydrocele''.
*[[AKA]] ''hydrocele''.
===General===
{{Main|Hydrocele testis}}
*Benign.
**May be seen in association with a testicular neoplasm.<ref name=pmid9490992>{{Cite journal  | last1 = Junnila | first1 = J. | last2 = Lassen | first2 = P. | title = Testicular masses. | journal = Am Fam Physician | volume = 57 | issue = 4 | pages = 685-92 | month = Feb | year = 1998 | doi =  | PMID = 9490992 }}</ref>
*Common.<ref name=pmid20705202>{{Cite journal  | last1 = Wampler | first1 = SM. | last2 = Llanes | first2 = M. | title = Common scrotal and testicular problems. | journal = Prim Care | volume = 37 | issue = 3 | pages = 613-26, x | month = Sep | year = 2010 | doi = 10.1016/j.pop.2010.04.009 | PMID = 20705202 }}</ref>
 
Clinical:
*Scrotal mass.
 
===Microscopic===
Features:
*Cyst lined by a simple ciliated epithelium.
*Does '''not''' contain sperm.
 
DDx:
*[[Spermatocele]] - contains sperm.
 
===Sign out===
<pre>
HYDROCELE SAC, LEFT, EXCISION:
- CONSISTENT WITH HYDROCELE SAC.
</pre>
 
<pre>
SOFT TISSUE ("HYDROCELE SAC"),LEFT, EXCISION:
- FIBROADIPOSE TISSUE COVERED BY MESOTHELIUM WITH REACTIVE CHANGES -- CONSISTENT
  WITH HYDROCELE SAC.
- EPIDIDYMIS WITH SPERM (INCIDENTAL FINDING).
</pre>
 
====Micro====
The sections shows fragments of tissue compatible with a benign cyst, that had a fibrous wall and was lined by a simple epithelium. No spermatocytes are identified.
 
Benign connective tissue (including skeletal muscle, nerves and blood vessels) is also present.


==Idiopathic granulomatous orchitis==
==Idiopathic granulomatous orchitis==
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DDx:
DDx:
*[[ITGCN]].
*[[GCNIS]] (ITGCN).
*[[Seminoma]].
*[[Seminoma]].
*Tertiary [[syphilis]] - classically, plasma cell rich.<ref name=pmid22343746>{{Cite journal  | last1 = Sekita | first1 = N. | last2 = Nishikawa | first2 = R. | last3 = Fujimura | first3 = M. | last4 = Sugano | first4 = I. | last5 = Mikami | first5 = K. | title = [Syphilitic orchitis: a case report]. | journal = Hinyokika Kiyo | volume = 58 | issue = 1 | pages = 53-5 | month = Jan | year = 2012 | doi =  | PMID = 22343746 }}</ref>
*Tertiary [[syphilis]] - classically, plasma cell rich.<ref name=pmid22343746>{{Cite journal  | last1 = Sekita | first1 = N. | last2 = Nishikawa | first2 = R. | last3 = Fujimura | first3 = M. | last4 = Sugano | first4 = I. | last5 = Mikami | first5 = K. | title = [Syphilitic orchitis: a case report]. | journal = Hinyokika Kiyo | volume = 58 | issue = 1 | pages = 53-5 | month = Jan | year = 2012 | doi =  | PMID = 22343746 }}</ref>
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*[[Lymphoma]].<ref name=pmid21458170/>
*[[Lymphoma]].<ref name=pmid21458170/>
*[[Malakoplakia]].<ref name=pmid21458170/>
*[[Malakoplakia]].<ref name=pmid21458170/>
*BCG-associated orchitis.<ref name=pmid23856256>{{Cite journal  | last1 = Parker | first1 = SG. | last2 = Kommu | first2 = SS. | title = Post-intravesical BCG epididymo-orchitis: Case report and a review of the literature. | journal = Int J Surg Case Rep | volume = 4 | issue = 9 | pages = 768-70 | month =  | year = 2013 | doi = 10.1016/j.ijscr.2013.05.017 | PMID = 23856256 }}</ref><ref name=pmid12841318>{{Cite journal  | last1 = Bulbul | first1 = MA. | last2 = Hijaz | first2 = A. | last3 = Beaini | first3 = M. | last4 = Araj | first4 = GF. | last5 = Tawil | first5 = A. | title = Tuberculous epididymo-orchitis following intravesical BCG for superficial bladder cancer. | journal = J Med Liban | volume = 50 | issue = 1-2 | pages = 67-9 | month =  | year =  | doi =  | PMID = 12841318 }}</ref>


===Stains===
===Stains===
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==Adenomatous hyperplasia of the rete testis==
==Adenomatous hyperplasia of the rete testis==
{{Main|Adenomatous hyperplasia of the rete testis}}
{{Main|Adenomatous hyperplasia of the rete testis}}
==Epidermoid cyst of the testis==
{{Main|Epidermoid cyst of the testis}}
==Testicular trauma==
===General===
*May lead to orchitectomy.
===Gross===
*Hemorrhagic.
===Microscopic===
Features:
*Necrotic seminiferous tubules.
*Intratubular blood in keeping with hemorrhage.
Note:
*Normal spermatogenesis in background - if viable tissue present.
===Sign out===
<pre>
Right Testicle Tissue, Debridement:
    - Hemorrhagic testicular tissue and necrotic seminiferous tubules.
    - Small amount of viable seminiferous tubules with spermatogenesis.
    - NEGATIVE for germ cell neoplasia in situ.
    - NEGATIVE for malignancy.
Comment:
The clinical history of trauma is noted.
</pre>


=Premalignant=
=Premalignant=
==Intratubular germ cell neoplasia==
==Germ cell neoplasia in situ==
*Abbreviated ''ITGCN''.
*Previously ''intratubular germ cell neoplasia'' (abbreviated ''ITGCN'').
{{Main|Intratubular germ cell neoplasia}}
{{Main|Germ cell neoplasia in situ}}


=Germ cell tumours=
=Germ cell tumours=
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{{Main|Seminoma}}
{{Main|Seminoma}}


==Spermatocytic seminoma==
==Spermatocytic tumour==
{{Main|Spermatocytic seminoma}}
*Previously ''spermatocytic seminoma''.
{{Main|Spermatocytic tumour}}


==Yolk sac tumour==
==Yolk sac tumour==
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==Fibrous pseudotumour of the paratesticular region==
==Fibrous pseudotumour of the paratesticular region==
{{Main|Fibrous pseudotumour of the paratesticular region}}
{{Main|Fibrous pseudotumour of the paratesticular region}}
==Testicular metastasis==
{{Main|Testicular metastasis}}


=See also=
=See also=
Michael
49,267

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