Difference between revisions of "Testicle"
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:*The size of the '''testis''' in 3 dimensions | :*The size of the '''testis''' in 3 dimensions | ||
:*The '''spermatic cord''' length and diameter | :*The '''spermatic cord''' length and diameter | ||
− | *[[Ink]] the tunica vaginalis. | + | *'''[[Ink]]''' the tunica vaginalis. |
*'''Cut''' through tunica vaginalis with scissors | *'''Cut''' through tunica vaginalis with scissors | ||
*'''Bisect''' the testis in the plane of the epididymis. | *'''Bisect''' the testis in the plane of the epididymis. | ||
Line 27: | Line 27: | ||
===Tissue selection=== | ===Tissue selection=== | ||
Generally including the following:<ref name=chicago/> | Generally including the following:<ref name=chicago/> | ||
− | *The '''proximal spermatic cord margin''' en face. | + | *The '''proximal spermatic cord margin''' {{en face}}. |
*For any tumor: | *For any tumor: | ||
:*At least '''1 section per cm of tumor''', including the closest penetration of tunica albuginea/vaginalis and epididymis. | :*At least '''1 section per cm of tumor''', including the closest penetration of tunica albuginea/vaginalis and epididymis. | ||
Line 35: | Line 35: | ||
*Any found '''lymph nodes''' | *Any found '''lymph nodes''' | ||
In case of orchiectomy for undescended testis, submit the entire testicular parenchyma to evaluate for GCNIS (germ cell neoplasia in situ).<ref name=chicago/> | In case of orchiectomy for undescended testis, submit the entire testicular parenchyma to evaluate for GCNIS (germ cell neoplasia in situ).<ref name=chicago/> | ||
+ | |||
+ | ==Evaluation== | ||
+ | Look mainly for: | ||
+ | *Tumors. | ||
+ | <gallery mode=packed heights=230> | ||
+ | File:Relative incidences of testicular tumors.png|Relative incidences of testicular tumors.{{MH}}<ref>{{cite journal| author=Gill MS, Shah SH, Soomro IN, Kayani N, Hasan SH| title=Morphological pattern of testicular tumors. | journal=J Pak Med Assoc | year= 2000 | volume= 50 | issue= 4 | pages= 110-3 | pmid=10851829 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10851829 }}</ref> | ||
+ | File:Seminoma (microscopic, H&E) (268018290).jpg|'''Seminoma''', with typical features:<ref>{{cite web|url=https://www.pathologyoutlines.com/topic/testisseminomas.html|title=Testis & paratestis.Germ cell tumors. Seminoma|author=Michelle R. Downes, M.D.|website=Pathology Outlines}} Last author update: 7 January 2020. Last staff update: 26 January 2021</ref><br>Sheets or lobular configuration with fibrous septae.<br>Pale cytoplasm (but may be eosinophilic).<br>Well defined cell membranes<br> | ||
+ | Nuclei being polygonal, and may have a flat edge giving.<br>Prominent central nucleoli. | ||
+ | </gallery> | ||
+ | {{Further|Tumor evaluation}} | ||
+ | *Optionally, disorders of spermatogenesis. | ||
+ | [[File:Spermatogenesis pathologies.png|850px|center]] | ||
{{Bottom}} | {{Bottom}} |
Revision as of 14:36, 18 June 2022
Author:
Mikael Häggström [note 1]
Contents
Gross processing
Triage
Usual steps:[1]
- Weigh the specimen.
- Measure:
- The size of the testis in 3 dimensions
- The spermatic cord length and diameter
- Ink the tunica vaginalis.
- Cut through tunica vaginalis with scissors
- Bisect the testis in the plane of the epididymis.
- Photograph the cut surface.
- If any tumor:
- Measure the size of the tumor in 3 dimensions
- Describe the gross appearance.
- Measure the distance of the tumor from the tunica vaginalis
- Note tumor extension: up to, into, or through the tunica albuginea or vaginalis.
- Measure the distance of the tumor from the epididymis and spermatic cord, and note any epididymal and spermatic cord involvement.
- Describe the remaining testicular parenchyma.
- If the specimen is large, serially section perpendicular to the long axis.
- Fix in formalin overnight.
Tissue selection
Generally including the following:[1]
- The proximal spermatic cord margin en face[note 2].
- For any tumor:
- At least 1 section per cm of tumor, including the closest penetration of tunica albuginea/vaginalis and epididymis.
- Grossly different areas of tumor to determine which components are present (in case of potential mixed germ cell tumor).
- Additional sections of the spermatic cord
- Normal (uninvolved) testis.
- Any found lymph nodes
In case of orchiectomy for undescended testis, submit the entire testicular parenchyma to evaluate for GCNIS (germ cell neoplasia in situ).[1]
Evaluation
Look mainly for:
- Tumors.
Seminoma, with typical features:[3]
Sheets or lobular configuration with fibrous septae.
Pale cytoplasm (but may be eosinophilic).
Well defined cell membranes
Further information: Tumor evaluation
- Optionally, disorders of spermatogenesis.
Notes
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
- ↑ En face means that the section is tangential to the region of interest (such as a lesion) of a specimen. Further information: Gross_processing#Cutting
Main page
References
- ↑ 1.0 1.1 1.2 Nicole Cipriani. Testis. The University of Chicago Department of Pathology. Retrieved on 2021-03-31.
- ↑ Gill MS, Shah SH, Soomro IN, Kayani N, Hasan SH (2000). "Morphological pattern of testicular tumors. ". J Pak Med Assoc 50 (4): 110-3. PMID 10851829. Archived from the original. .
- ↑ Michelle R. Downes, M.D.. Testis & paratestis.Germ cell tumors. Seminoma. Pathology Outlines. Last author update: 7 January 2020. Last staff update: 26 January 2021
Image sources
- ↑ Image(s) by: Mikael Häggström, M.D. Public Domain
- Author info
- Reusing images