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Testicular tumors and STDs. Dr. Basu MD. Our topic. Classification of testicular tumor. Seminoma Embryonal carcinoma Yolk sac tumor Choriocarcinoma Teratoma Diagnosis of these tumors. What you should know about a Testicular tumor. Age Gross and microscopy Markers

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Testicular tumors and STDs

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Presentation Transcript
our topic
Our topic
  • Classification of testicular tumor.
  • Seminoma
  • Embryonal carcinoma
  • Yolk sac tumor
  • Choriocarcinoma
  • Teratoma
  • Diagnosis of these tumors
what you should know about a testicular tumor
What you should know about a Testicular tumor
  • Age
  • Gross and microscopy
  • Markers
  • Clinical Presentation
classification of testicular tumor
Classification of testicular tumor.
  • Tumor arising from the Germ cells
  • Tumor arising from Leydig cells( produce endocrine abnormality).
  • Tumor arising from Sertoli cells.
tumor arising from the germ cells
Tumor arising from the Germ cells
  • Tumors with one histological pattern
  • Seminoma
  • Embryonal carcinoma
  • Yolk sac tumor
  • Choriocarcinoma
  • Teratoma
  • Tumor with more than one histological pattern
  • Miscellaneous
seminoma classic
Seminoma [Classic]
  • Most common types of testicular neoplasm.
  • Age : 15 to 34 years
  • Note:
    • Some Seminoma may contain trophoblastic content.
    • In these type of Seminoma Beta-HCG will be mildly elevated.
variant of seminoma
Variant of Seminoma

Variant : Spermatocytic Seminoma

    • In this case metastasis is rare, common in old people.
  • Three types of cell are seen
    • large multinucleated cells,
    • medium size cells and
    • small cells that reminiscent of spermatocytes
seminoma gross
Seminoma Gross

Features : large, soft, homogenous, grey-white

seminoma microscopy
Seminoma : Microscopy
  • Seminoma cells ([ PAS positive] : Large cells with distinct border , round nuclei and prominent nucleoli.
  • Lymphocytes, plasma cell in stroma.
embryonal carcinoma
Embryonal carcinoma

Age : 20-30 years.

Features :

  • Often multiple metastasis is present at the time of diagnosis.
  • Often it contain other foci of Yolk sac tumor, teratoma and Chorio-carcinoma.
  • So both AFP and beta hcG will be elevated ( non specific)
embryonal carcinoma1
Embryonal carcinoma

Features : Red to tan to brown areas, including prominent hemorrhage and necrosis.

embryonal carcinoma and teratoma teratocarcinoma
Embryonal carcinoma and Teratoma [ Teratocarcinoma]

Features : Chondroid white areas (teratoma) in a Embryonal carcinoma.

teratoma in testis
Teratoma in testis
  • Age = all ages
  • Almost always malignant ( unlike ovary – where it is usually benign)
yolk sac tumor endodermal sinus tumor
Yolk sac tumor [ endodermal sinus tumor]
  • Age : 3 years
  • Histology : Presence of Schiller –Duvall body ( glomeruloid body)
  • Specific Marker = AFP
  • Age = 20 -30
  • Pure Chorio carcinoma is rare in testis.
  • It is always mixed with Teratoma, or other tumor even with Seminoma.
  • Histology : Malignant cyto and syncytiotrophoblast without villous formation.
  • Specific Marker = beta hcG
mixed tumor
Mixed tumor
  • Add………….
leydig cell tumor clinical features
Leydig cell tumor : Clinical features

Small( 1-3 cm), nodular, circumscribed tumor, yellowish in colour

Bilateral gyenecomastia and testicular enlargement force the patient to seek medical assistance.

quiz name the markers
Quiz : name the markers





AFP and hcG

testicular tumor clinical features
Testicular tumor; clinical features
  • Painless swelling
  • Seminoma usually confined to testis.
  • Other non-seminomatous tumor widely metastasize .
  • Metastasis occur by both hematgenous and lymphatic route.
secondary syphilis
Secondary syphilis

Strongly Positive both

  • Anti treponomal antibody test and
  • Nontrepomomal test

Positive anti treponomal antibody test.

Negative – Nontrepomomal antibody test

gonorrhea clinical features
Gonorrhea ; clinical features
  • Male : Epididymitis, may involve prostate.
  • Female : salpingitis, infertility
  • Infants ( during delivery) : Purulent infection of the eye : Ophthalmia neonatorum).
lymphogranuloma venereum lgv lymphadenopathy
Lymphogranuloma Venereum, LGV lymphadenopathy.

Mixed Granulomatous and neutrophilic inflammation.

diagnosis lgv
Diagnosis - LGV
  • Demonstration of organism in Biopsy section / exudates- in active lesion.
  • ELISA performed on serum.
soft chancre chancroid in hemophilus ducreyi infection ulcer contain yellowish exudates
“Soft chancre” –Chancroid in Hemophilus ducreyiinfection. Ulcer contain yellowish exudates.
syphilis secondary maculopapular rash
Syphilis ( secondary – maculopapular rash)

Histology shows plasma cells and lymphocytes

syphilis secondary condylomata lata this broad base elevated lesion seen in the moist areas
Syphilis - Secondary :: Condylomata lata -This broad base, elevated lesion seen in the moist areas.
cause of false positive vdrl test
Cause of false positive VDRL test
  • SLE
  • Lepromatous leprosy
  • Pregnancy
  • Antiphospholipid syndrome