Pathology Notes

Practice questions answers Male reproductive system II © Jun Wang, MD, PhD 1. C. Large atypical cells with clear cytoplasm limited within the tubules without spermatogenesis is most consistent intratubular germ cell neoplasia . Embryonal carcinoma is characterized by primitive epithelial cells with minimal differentiation and positive reactivity to CD30 and cytokeratin.   Hairy cell leukemia has “fried egg” appearance, but usually are seen in marrow, in a background for pancytopenia. Seminoma cells have same morphology as intratubular germ cell neoplasia , but the tumor is not limited to tubules. Teratoma has differentiated tissue, such as skin and adnexa, etc. None of these will be limited to tubules. 2. D. Sheets of large testicular tumors with round nuclei and clear cytoplasm is highly suggestive of seminoma , unless a secondary neoplastic components are identified. These tumor cells are positive for PLAP, KIT and OCT3/4. Diffuse large B cell lymphoma is the mo

Practice questions answers Male reproductive system I © Jun Wang, MD, PhD 1. E. Screening test for syphilis has been recommended for all sexually active patients with genital ulcers, especially painless hard ulcers. These screening tests including rapid plasma reagin and venereal disease research laboratory (VDRL). Fluorescent treponemal antibody absorption and treponema pallidum hemagglutination assay are confirmation tests, performed after the screening tests are positive. Culture and gram stain for ulcer debris may growth various bacteria, but not treponema pallidum, the microorganism causing syphilis . Human papilloma virus is associated with condyloma and many penile squamous neoplasia , but not syphilis . 2. B. See discussion in question 1. 3. E. Treponema pallidum causes syphilis . Chlamydia trachomatis is the most common sexually transmitted infection, and is associated with various conditions, including lymphogranuloma venereum and pelvic inflammatory dise

Practice questions II Male reproductive system © Jun Wang, MD, PhD 1. A 45-year-old man presents with a painless swelling of his right testicle for 3 months. He denies fever, weight loss and night sweating. His past medical history is unremarkable. Physical examination reveals a 7.5 cm firm non tender right testis. Laboratory test results, including CBC, AFP, beta hCG, and LDH, are all within normal ranges. Sonographic examination reveals a bulky right testicle with an ill-defined mass. Right orchiectomy is performed. Microscopically, the mass contains tubules with thickened basement membrane. Many large atypical cells with clear cytoplasm are seen within the tubules. These cells have a fried egg appearance. No spermatogenesis is noted. No atypical cells are seen outside the tubules. What is the diagnosis? A. Embryonal carcinoma B. Hairy cell leukemia C. Intratubular germ cell neoplasia D. Seminoma E. Teratoma 2. Use this case for next three questions . A 43-year

Practice questions I Male reproductive system © Jun Wang, MD, PhD 1. Use this case for next four questions . A 28-year-old man presents with a hard painless ulcer at his glans for 2 weeks. He is sexually active with multiple sexual partners. He is HIV negative and past medical history is unremarkable. Physical examination reveals a 1.5 cm discrete, nontender superficial ulcer at the base of his glans. His routine laboratory tests are within normal range. What is the proper test like to lead to diagnosis? A. Culture of ulcer debris B. Fluorescent treponemal antibody absorption C. Gram stain for ulcer debris D. PCR for human papilloma virus E. Rapid plasma reagin 2. A 28-year-old man presents with a hard painless ulcer at his glans for 2 weeks. He is sexually active with with multiple sexual partners. He is HIV negative and past medical history is unremarkable. Physical examination reveals a 1.5 cm discrete, nontender superficial ulcer at the base of his glans s