Testicular & Paratesticular Diseases

• Medical:
  • [sperm morphology]
  • testicular biopsies:
    • aspermia work-up: if tubules OK and lots of sperm, then mechanical blockage is between testicle and ejaculatory duct
    • hypospermia work-up:

• benign:
  • tunica fibroma or fibromatosis
• malignant:
  • pure seminomatous:
    1. cytological features: on Pap or Wright's stain, the fragile cytoplasm leaks and forms a lacy "tigroid" background pattern [LMC-02-3339]; cellular smear, dispersed cells, large nuclei with distinct nucleoli, pale cytoplasm
    2. histology:
       • The first is classic seminoma, and it has a uniform population of large cells that form sheets and nests separated by delicate connective tissue (see Images 3-4). Leukocytic infiltration (20%), multinucleated cells, syncytiotrophoblasts (7-35%), and microcalcifications (60%) may be present. Upon gross examination, the tumor has a uniform yellow color and bulges from the cut surface. Classic seminoma is the most common histologic type.
       • The second is anaplastic seminoma, and it is observed in 5-15% of patients with seminomas. Histopathology is as described for classic seminoma but with increased mitotic figures. Patients tend to present at more advanced stages than those with classic seminoma, but stage prognosis is similar.
       • The third is spermatocytic seminoma, and it is a rare variant that occurs in older adults. Histopathology shows tumor cells arranged in solid sheets, containing poorly developed inconspicuous septae without leukocytic infiltrate. No glycogen is present. Small, medium, and large cell types are observed. Orchiectomy alone is sufficient treatment; metastases are rare.
• non-pure-seminomatous:
  1. embryonal: cytology of cellular smears, aggregates, large nuclei, large nucleoli
• The Testicular Cancer Resource Center

• Cysts:
  • spermatocoel: should see spermatocytes in lumen and some ciliated lining cells
  • mesothelial inclusion cyst:[LMC-04-1924; LMC-04-6249]
  • chylocoel of tunica:
• inlammatory lesions:
  • spermatic granuloma:
  • epididymitis: post vasectomy vs. "intact" vas
  • torsion & trauma:

(posted 6/11/02; latest addition 13 April 2007)