Male Genital Pathology | Hasnat Hussain (Reus-11)

Male Genital System

Q.1) Give a pathologic classification of testicular tumors. Name the two
histological variants of seminoma. Which germ cell tumour of testis is
common in infancy and childhood?
ANS:
Pathological classification of testicular tumors:
Germ cell tumors
1. Seminomatous tumors
 Classical seminoma
 Spermatocytic seminoma

2. Non semiomatous tumors

 Embryonal carcinoma
 Yolk sac tumour
 Choriocarcinoma
 Teratoma

Sex cord-stromal tumors

1. Leydig cell tumour
2. Sertoli cell tumor

Histological variants of seminoma:

 Classical seminoma
 Spermatocytic seminoma

Gem cell tumour of the testis which is common in infants and child:
 Yolk sac tumor

Q.2) What is benign prostatic hyperplasia? Give its morphology. Give the
pathogenesis of prostate adenocarcinoma.

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 Male Genital Pathology | Hasnat Hussain (Reus-11)

ANS:
Benign prostatic hyperplasia:
“Non-malignant enlargement of the prostate caused by nodular hyperplasia of prostatic
stroma and epithelium. It often leads to urinary obstruction.”

Morphology:
Gross
 Occur in the inner transitional zone of the prostate
 Prostate is enlarged and contains many nodules
 Nodules can be solid or cystic
 Urethra is compressed by the nodules to a narrow slit
 Sometimes the nodules may project into the bladder lumen and cause ball-valve type
of urethral obstruction
Microscopic
 Hyperplastic nodules are composed of proliferating glands and fibromuscular stroma
 The glands are lined by tall columnar epithelium
 Lumen of the glands contain proteinaceous material called corpora amylacea.

Pathogenesis of prostate adenocarcinoma:

Androgens, heredity, environmental factors and acquired somatic mutations have roles in
the development of prostate cancer.
1. Androgens
Evidence that lead to the concept that androgens play a role in carcinoma prostate
are;
 Castrated men don’t develop prostate cancer due to low level of androgens in
them
 Cancer regresses on anti-androgen therapy
2. Heredity
 Increased risk in first degree relatives of patients with prostate cancer
 Uncommon in Asians
3. Environmental factors
 Western diet
 Western environment (industrialization)

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 Male Genital Pathology | Hasnat Hussain (Reus-11)

4. Acquired somatic mutations

 TMPRSS2-ETS fusion gene
 PTEN mutation (tumour suppressor gene)

Excess androgens + heredity + environmental factors + acquired mutations  carcinoma

prostate

Q.3) Classify testicular germ cell tumors. Give a brief account of morphology of
seminoma testis.
ANS:
Testicular germ cell tumors:
 Classified previously.

Morphology of seminoma testis:

Gross
 Testis enlarged
 Soft, well demarcated, grey-white tumors
 Bulge out from the cut surface
Microscopic
 Composed of large, uniform cells with clear glycogen-rich cytoplasm and round nuclei
with prominent nucleoli
 Cells are arranged in small lobules with intervening fibrous septa
 Lymphocytic infiltrate is often present
 Sometimes a granulomatous reaction may also be present
 In 15% of cases, syncitiotrophoblasts are present in the tumor which secrete hCG.

Q.4) Classify testicular tumors. Describe the morphology of seminoma testis.

Enumerate the causes of atrophic testes.
ANS:

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 Male Genital Pathology | Hasnat Hussain (Reus-11)

Classification of testicular tumors:

 Classified previously.
Morphology of seminoma testis:
 Described previously.

Causes of atrophic testis:

 Cryptorchidism
 Atherosclerotic narrowing of the testicular vessels
 Severe orchitis (inflammation of testes)
 Hypopituitarism
 Malnutrition or cachexia
 Irradiation
 Prolonged administration of anti-androgens
 Kilnefelter syndrome
 Persistent stimulation by high levels of FSH

Q.5) Define choriocarcinoma. Write down the morphology of

choriocarcinoma.
ANS:
Choriocarcinoma:
“A very aggressive malignant tumour of the uterus that arises from the gestational
chorionic epithelium or less frequently from the gonadal germ cells.”

Morphology of choriocarcinoma:
Gross
 Soft, fleshy, yellow-white tumor
 Large areas of haemorrhage and necrosis are present
Microscopic
 No chorionic villi
 Composed of anaplastic cuboidal cytotrophoblasts and syncitiotrophoblasts
 Invades the myometrium and vessels very early in the course

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 Male Genital Pathology | Hasnat Hussain (Reus-11)

Q.6) Classify testicular tumors. Briefly describe the gross appearance of

“classical” or “typical” seminoma. Write three identification points of
microscopic picture of seminoma.
ANS:
Classification of testicular tumors:
 Classified previously.
Gross appearance of classical or typical seminoma:
 Testis enlarged
 Soft, well demarcated, grey-white tumors
 Bulge out from the cut surface

Identification points of microscopic picture of seminoma:

 Composed of large, uniform cells with clear glycogen-rich cytoplasm and round nuclei
with prominent nucleoli
 Cells are arranged in small lobules with intervening fibrous septa
 Lymphocytic infiltrate

Prepared By: Hasnat Hussain (Reus-11) 