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      Pseudoneoplastic lesions of the testis and paratesticular structures

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          Abstract

          Pseudotumors or tumor-like proliferations (non-neoplastic masses) and benign mimickers (non-neoplastic cellular proliferations) are rare in the testis and paratesticular structures. Clinically, these lesions (cysts, ectopic tissues, and vascular, inflammatory, or hyperplastic lesions) are of great interest for the reason that, because of the topography, they may be relevant as differential diagnoses. The purpose of this paper is to present an overview of the pseudoneoplasic entities arising in the testis and paratesticular structures; emphasis is placed on how the practicing pathologist may distinguish benign mimickers and pseudotumors from true neoplasia. These lesions can be classified as macroscopic or microscopic mimickers of neoplasia.

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          From the archives of the AFIP: extratesticular scrotal masses: radiologic-pathologic correlation.

          Paula Woodward, Cornelia M Schwab, Isabell Sesterhenn (2015)
          The extratesticular scrotal contents consist of the epididymis, spermatic cord, and fascia derived from the embryologic descent of the testis through the abdominal wall. As opposed to intratesticular masses, most extratesticular masses are benign. Cystic masses (including hydroceles, epididymal cysts, and varicoceles) are easily diagnosed with ultrasonography (US) and are benign. Epididymitis is a common extratesticular lesion as well as the most frequent cause of an acute scrotum. It may be either acute or chronic and can be potentially complicated by epididymo-orchitis or scrotal abscess. Findings include epididymal enlargement, skin thickening, hydroceles, and hyperemia. The epididymis can also be affected by sarcoidosis, a noninfectious granulomatous disorder. The most common extratesticular neoplasms are lipomas (most often arising from the spermatic cord) and adenomatoid tumors (most often found in the epididymis). Despite their relative rarity, malignant neoplasms do occur and include rhabdomyosarcoma, liposarcoma, leiomyosarcoma, malignant fibrous histiocytoma, mesothelioma, and lymphoma. These tumors are often large at the time of presentation. The US findings of solid masses are often nonspecific. Magnetic resonance imaging can be very helpful in the evaluation of some of these disorders, allowing for a more specific diagnosis in cases of lipoma, fibrous pseudotumor, and polyorchidism. Copyright RSNA, 2003.
          Article 0 comments Cited 45 times – based on 0 reviews     Review now
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            From the archives of the AFIP: tumors and tumorlike lesions of the testis: radiologic-pathologic correlation.

            Paula Woodward, Roya Sohaey, Michael J O'Donoghue … (2016)
            Testicular carcinoma represents only 1% of all neoplasms in men, but it is the most common malignancy in the 15-34-year-old age group. Germ cell tumors constitute 95% of all testicular tumors. Germ cell tumors are a varied group of neoplasms whose imaging features reflect their underlying histologic characteristics. Seminomas are generally well-defined homogeneous lesions, whereas the nonseminomatous tumors (embryonal carcinoma, yolk sac tumor, choriocarcinoma, teratoma, and mixed germ cell tumor) have a much more varied appearance. Germ cell tumors follow a predictable pattern of spread via the lymphatic drainage to the retroperitoneal nodes. Choriocarcinoma, which has a proclivity for early hematogenous spread, is a notable exception. Testicular tumors may also arise from the sex cords (Sertoli cells) and stroma (Leydig cells). Although 90% of these tumors are benign, there are no reliable imaging criteria to differentiate them from malignant masses. Some benign testicular masses can be recognized, obviating an unwarranted orchiectomy. A dilated rete testis is a normal variant and appears as a series of small tubules near the mediastinum testis. Other benign lesions that can be suspected on the basis of imaging findings and history include intratesticular cysts, epidermoid cysts, congenital adrenal hyperplasia, and sarcoidosis. Copyright RSNA, 2002
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              Malakoplakia: evidence for monocyte lysosomal abnormality correctable by cholinergic agonist in vitro and in vivo.

              W Gourley, N Lindsey, U Nilsson … (1977)
              We studied monocyte function in a case of malakoplakia in an attempt to characterize the immune defect in this condition. Our patient's intracellular cyclic-GMP levels were abnormally low (mean +/- S.D. of 0.17 +/- 0.05 pmol per 10(7) malakoplakia cells, versus 0.79 +/- 0.12 in normals) p less than 0.001). After phagocytosis, his monocytes failed to release beta-glucuronidase. In the bactericidal assay, incubation of the patient's monocytes with Escherichia coli allowed growth of 542 +/- 46 colonies, normal monocytes allowed 95 +/- 22 (p less than 0.001). The percentage of monocytes with large lysosomal granules was 23 +/- 4 in the patient and 4 +/- 2 in normal controls. After in vitro incubation of the patient's cells or in vivo treatment with bethanechol chloride, the cyclic-GMP levels, bactericidal ability and lysosomal granules of the cells returned to normal levels. Low levels of cyclic-GMP could impair lysosomal function and bacterial killing in this condition. Cholinergic agonists correct the in vitro abnormalities and are beneficial in vivo.
              Article 0 comments Cited 24 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                : +34-93-4169700 , +34-93-4169730 , falgaba@fundacio-puigvert.es
                Journal
                Journal ID (nlm-ta): Virchows Arch
                Title: Virchows Archiv
                Publisher: Springer-Verlag (Berlin/Heidelberg )
                ISSN (Print): 0945-6317
                ISSN (Electronic): 1432-2307
                Publication date (Electronic): 6 September 2007
                Publication date (Print): December 2007
                Volume: 451
                Issue: 6
                Pages: 987-997
                Affiliations
                [1 ]Pathology section, Fundació Puigvert, Barcelona, Spain
                [2 ]Department of Morphological Sciences, School of Medicine, Universitat Autónoma de Barcelona (UAB), Barcelona, Spain
                [3 ]Institute of Pathology, Leopold Franzens University, Innsbruck, Austria
                [4 ]Pathology Service, Hopital Armand-Trouseau, Assistance Publique, Hôpitaux de Paris, Paris, France
                [5 ]Department of Pathology, Clínica Plató-Fundació Privada, Barcelona, Spain
                [6 ]Institute of Pathological Anatomy and Histopathology, School of Medicine, Polytechnic University of the Marche-Region, Ancona, Italy
                [7 ]International Agency for Research on Cancer (IARC), Lyon, France
                [8 ]Department of Pathology, Reina Sofia University Hospital and Córdoba University Medical School, Córdoba, Spain
                Article
                Publisher ID: 502
                DOI: 10.1007/s00428-007-0502-8
                PMC ID: 2082069
                PubMed ID: 17805564
                SO-VID: fd664878-ecba-490f-a11f-d247053ddbcb
                Copyright © © Springer-Verlag 2007
                History
                Date received : 3 July 2007
                Date revision received : 31 July 2007
                Date accepted : 15 August 2007
                Categories
                Subject: Review and Perspective
                Custom metadata
                issue-copyright-statement © Springer-Verlag 2007

                ScienceOpen disciplines: Pathology
                Keywords: paratesticular structures,testis,benign mimics,pseudotumor,tumor-like
                Data availability:
                ScienceOpen disciplines: Pathology
                Keywords: paratesticular structures, testis, benign mimics, pseudotumor, tumor-like

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