Superpage - Images
Testis & paratestis

Authors: Andres Acosta, M.D., Turki Al-Hussain, M.D., William Anderson, M.D., Manju Aron, M.D., Ritu Bhalla, M.D., Melanie Bourgeau, M.D., Zhengshan Chen, M.D., Ph.D., Maurizio Colecchia, M.D., Kristine M. Cornejo, M.D., J. Cody Craig, M.D. , Christopher Dall, M.D., Michelle R. Downes, M.D. , Sara Moscovita Falzarano, M.D., Ph.D., Sarah Findeis, M.D., Jerad M. Gardner, M.D., Sarwat I. Gilani, M.B.B.S., Jennifer B. Gordetsky, M.D., Priyanka Gupta, M.B.B.S., D.N.B., Rui Henrique, M.D., Ph.D., He Huang, M.D., Ph.D., Kenneth A. Iczkowski, M.D., Rafael E. Jimenez, M.D., M.H.A., Andre Kajdacsy-Balla, M.D., Ph.D., Oleksandr Kravtsov, M.D., Anastasia Lendel, B.A., João Lobo, M.D., Virgilia Macias, M.D., Andres Matoso, M.D., Vikas Mehta, M.D., Hector Mesa, M.D., Ph.D., Brandon Douglas Metcalf, M.D., Vaishali Pansare, M.D., Anil Parwani, M.D., Ph.D., M.B.A., Ashley Patton, D.O., Ph.D., Giacomo Maria Pini, M.D., Swapnil U. Rane, M.D., Julia Rivera, M.D., Francesca Sanguedolce, M.D., Ph.D., Mit D. Shah, B.S., Stephanie Siegmund, M.D., Ph.D., Nadarra L. Stokes, M.D., Lauren N. Stuart, M.D., M.B.A., Burak Tekin, M.D., Alyssa Thompson, B.S., Jason Tretter, Veronica Ulici, M.D., Ph.D., Aida Valencia, M.D., Gang Wang, M.D., Ph.D. , Sean R. Williamson, M.D., Patricija Zot, M.D., Debra L. Zynger, M.D.
Resident / Fellow Advisory Board: Alcino Pires Gama, M.D.
Editorial Board Members: Bonnie Choy, M.D., Maria Tretiakova, M.D., Ph.D., Debra L. Zynger, M.D.
Deputy Editor-in-Chief: Maria Tretiakova, M.D., Ph.D.
Editor-in-Chief: Debra L. Zynger, M.D.

Copyright: 2002-2024, PathologyOutlines.com, Inc.

GU related: Jobs, Fellowships, Conferences, Cases, CME, Board Review

Related chapters: Penis & scrotum, Prostate gland & seminal vesicles

Editorial Board oversight: Debra L. Zynger, M.D. (last reviewed March 2024)

Adenocarcinoma
Gross images

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Mass in testicular hilum

Mass in testicular hilum

Solid mass with cystic areas

Solid mass with cystic areas

Microscopic (histologic) images

Contributed by Rafael E. Jimenez, M.D.
Areas of central necrosis

Areas of central necrosis

Complex architecture

Complex architecture

Transition of epithelium Transition of epithelium Transition of epithelium

Transition of epithelium


Complex tubuloglandular pattern

Complex tubuloglandular pattern

Cribriform pattern

Cribriform pattern

High grade cytomorphology

High grade cytomorphology

Increased mitotic activity

Increased mitotic activity


Adenocarcinoma of epididymis
Microscopic (histologic) images

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Missing Image

Adenocarcinoma of rete testis


Adenomatoid tumor
Radiology images

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Coronal MR

Ultrasound

Gross images

Contributed by Debra L. Zynger, M.D.

Paratesticular tumor



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Well circumscribed tumor

Microscopic (histologic) images

Contributed by Sarah Findeis, M.D., Stephanie J. Conrad, M.D., Ming Zhou, M.D.,
the Genitourinary Pathology Society (GUPS) and @katcollmd on Twitter

Interface with testis

Cords and trabeculae pattern

Eosinophilic cells

Calretinin

CK AE1/3

Circumscribed tumor


Dilated cystic spaces

Vacuolated and attenuated epithelium

Bland nuclei

Calretinin

Adenomatoid tumor Adenomatoid tumor

Adenomatoid tumor


Adenomatoid tumor Adenomatoid tumor

Adenomatoid tumor

Adenomatoid tumor Adenomatoid tumor

Adenomatoid tumor

Adenomatoid tumor Adenomatoid tumor

Adenomatoid tumor

Cytology images

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Moderate cellularity

Monolayered sheets of cells


Adrenal cortical rests
Microscopic (histologic) images

Contributed by Yuto Yamazaki, M.D., Ph.D., Hironobu Sasano, M.D., Ph.D., Debra L. Zynger, M.D. and Sean R. Williamson, M.D.
Adrenal rest Nests of cortical cells SF1

Spermatic cord adrenal rest and SF1


Radical orchiectomies / spermatic cords with adrenal rests Radical orchiectomies / spermatic cords with adrenal rests Radical orchiectomies / spermatic cords with adrenal rests

Spermatic cord adrenal rests


Radical orchiectomies / spermatic cords with adrenal rests Radical orchiectomies / spermatic cords with adrenal rests

Paratesticular adrenal cortical rest


Adult granulosa cell tumor
Radiology images

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Hypoechoic lesion

Hypoechoic lesion

Hypoechoic lesion and increased vascularity

Hypoechoic lesion /
increased vascularity

Increased vascularity

Increased vascularity

Gross images

Contributed by Kristine M. Cornejo, M.D.
Tan-yellow solid mass

Tan-yellow solid mass

Lobulated tan-yellow mass

Lobulated tan-yellow mass

Microscopic (histologic) images

Contributed by Kristine M. Cornejo, M.D.
Nodular appearance

Nodular appearance

Nuclear grooves

Nuclear grooves

Diffuse pattern

Diffuse pattern

Spindled pattern

Spindled pattern

Corded pattern

Corded pattern

Gyriform / watered-silk pattern

Gyriform / watered silk pattern


Microfollicular pattern (Call-Exner Bodies) Microfollicular pattern (Call-Exner Bodies) Microfollicular pattern (Call-Exner Bodies) Microfollicular pattern (Call-Exner Bodies)

Microfollicular pattern (Call-Exner bodies)

Insular pattern

Insular pattern

Palisading pattern

Palisading pattern


Pseudopapillary pattern

Pseudopapillary pattern

Herringbone / fascicular pattern

Herringbone / fascicular pattern

Leutinized cells

Luteinized cells

Inhibin A stain

Inhibin A stain


Anatomy & histology
Diagrams / tables

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Scrotum

Transverse section

Right testis

Vertical section

Transverse section


Section of genital cord

Spermatic cord

Subcutaneous inguinal ring

Cremaster

Spermatic veins

Section of epididymis of guinea pig


Fundus of bladder

Gross images

Contributed by @Andrew_Fltv on Twitter
Testis anatomy Testis anatomy

Testis anatomy



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Normal testis

Microscopic (histologic) images

Contributed by Asmaa Gaber Abdou, M.D. and @Andrew_Fltv on Twitter
Testis histology Testis histology

Testis histology



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Normal testis

Efferent ducts

Leydig cells


Seminiferous tubules


Various images of epididymis


Various images of spermatic cord


Atrophy
Gross images

Contributed by @Andrew_Fltv on Twitter
Testicular atrophy

Testicular atrophy



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Comparison to normal testis

Microscopic (histologic) images

Contributed by Patricija Zot, M.D., Rafael E. Jimenez, M.D., @ThatGlassTho on Twitter and @Andrew_Fltv on Twitter

Seminiferous tubules replaced by collagen deposition

Retained germ cells

Atrophy Atrophy

Atrophy


Testicular atrophy Testicular atrophy Testicular atrophy

Testicular atrophy


Choriocarcinoma
Radiology images

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CT with testicular mass

Testis ultrasound with calcification

Chest Xray with nodules

Chest Xray in choriocarcinoma syndrome


Chest CT with cannonball metastasis

MRI of brain

Abdominal CT with retroperitoneal mass

Abdomen CT with liver metastasis

Gross images

Contributed by Debra L. Zynger, M.D. and Andres Matoso, M.D.
Mixed GCT with predominately choriocarcinoma Mixed GCT with predominately choriocarcinoma

Mixed GCT with predominate choriocarcinoma

Mixed GCT with minor component of choriocarcinoma Mixed GCT with minor component of choriocarcinoma Mixed GCT with minor component of choriocarcinoma

Mixed GCT with minor component of choriocarcinoma

Large hemorrhagic tumor

Microscopic (histologic) images

Contributed by Debra L. Zynger, M.D.
2 cell types 2 cell types

2 cell types

Hemorrhage

Hemorrhage

Syncytiotrophoblasts

Syncytiotrophoblasts

Syncytiotrophoblast rim Syncytiotrophoblast rim

Syncytiotrophoblast rim


Mononucleated trophoblasts Mononucleated trophoblasts Mononucleated trophoblasts

Mononucleated trophoblasts


Choriocarcinoma with IHC

Choriocarcinoma with IHC

bhCG

Beta hCG

Inhibin

Inhibin

CK7

CK7

GATA3

GATA3

OCT 3/4

OCT 3/4


Cryptorchidism
Clinical images

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Intra-abdominal mass

Abdominal testis

Mass with right gonadal vein

Scrotum with cryptorchidism

Abdominal wall ectopic testis

Gross images

Contributed by Debra L. Zynger, M.D.

Cryptorchid testicle

Microscopic (histologic) images

Contributed by Debra L. Zynger, M.D.

Sertoli cell only tubules

Absent spermatogenesis

Peritubular fibrosis

Sertoli cell nodule


Retained Leydig cells

Granular cell change within Sertoli cells

Microliths


Cystic trophoblastic tumor
Microscopic (histologic) images

Contributed by Vikas Mehta, M.D.
Cyst, fibrinoid material

Cyst, fibrinoid material

Intermediate type trophoblasts Intermediate type trophoblasts

Intermediate type trophoblasts

Intermediate trophoblasts, smudged chromatin

Intermediate trophoblasts, smudged chromatin

Solid nest, fibrinoid material

Solid nest, fibrinoid material

βhCG positivity

βhCG positivity


Cysts
Radiology images

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Cyst of testis (focal dilatation of seminiferous tubule)

Cyst of testis (focal dilatation of seminiferous tubule)

Cystic dilatation (tubular ectasia) of rete testis

Cystic dilatation (tubular ectasia) of rete testis

Epididymis cyst

Epididymis cyst

Cystic dilatation (tubular ectasia) of epididymis

Cystic dilatation (tubular ectasia) of epididymis


Mesothelial cyst in tunica albuginea

Mesothelial cyst in tunica albuginea

Hydrocele

Hydrocele

Chronic hydrocele with multiloculated appearance

Chronic hydrocele with multiloculated appearance

Spermatic cord cyst

Spermatic cord cyst

Gross images

AFIP images
Cyst of tunica albuginea

Cyst of tunica albuginea



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Encysted hydrocele

Encysted hydrocele

61 year old man

Multiple paratesticular, unilocular, thin walled cysts

Microscopic (histologic) images

Contributed by Stephanie Siegmund, M.D., Ph.D. and AFIP
Mesothelium lined cystic cavity

Mesothelium lined cystic cavity

Mesothelial lining of hydrocele

Mesothelial lining of hydrocele

Cystic dilatation of epididymis Cystic dilatation of epididymis

Cystic dilatation of epididymis


Cystic dilatation of epididymis

Cystic dilatation of epididymis

Spermatocele

Spermatocele

Ruptured spermatocele

Ruptured spermatocele

Cyst of tunica albuginea

Cyst of tunica albuginea


Embryonal carcinoma
Radiology images

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Calcified mass

Clinical images

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Cryptorchid testis with embryonal carcinoma

Gross images

Contributed by Debra L. Zynger, M.D.

Mixed GCT with predominance of embryonal carcinoma

Mixed GCT with minor component of embryonal carcinoma

Microscopic (histologic) images

Contributed by Debra L. Zynger, M.D.

Solid growth

Glandular growth

Papillary growth


Cellular overlap

Pleomorphic

Admixed with yolk sac tumor

Intratubular

Lymphovascular invasion

Spermatic cord invasion


OCT 3/4

CD30

PLAP

CD117

D2-40

AE1 / AE3


Epidermoid cyst
Microscopic (histologic) images

Contributed by Debra L. Zynger, M.D. and @ThatGlassTho on Twitter

Testicular epidermoid cyst

Cyst wall with adjacent normal seminiferous tubule

Lamellar keratin within the cyst

Stratified squamous epithelium with adjacent keratin

Teratoma-epidermoid cyst Teratoma-epidermoid cyst

Teratoma - epidermoid cyst

Molecular / cytogenetics images

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Normal FISH for 12p


Epididymitis
Microscopic (histologic) images

Contributed by Veena Maheshwar, M.D., Kiran Alam, M.D., Anshu Jain, M.D.

25 year old man with epididymal mass: filiarial epididymitis


Epithelioid trophoblastic tumor
Microscopic (histologic) images

Contributed by Debra L. Zynger, M.D.
Tumor metastatic to shoulder

Tumor metastatic to shoulder

Mononucleate cells

Mononucleate cells

Prominent cell borders

Prominent cell borders


Fibroma thecoma group
Gross images

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Well circumscribed intratesticular tumor

Microscopic (histologic) images

Contributed by Rafael E. Jimenez, M.D., M.H.A.
Bland nuclei

Bland nuclei

Fascicular pattern

Fascicular pattern

Encapsulated tumor

Encapsulated tumor

Collagenized stroma

Collagenized stroma

Inhibin

Inhibin

SF1

SF1


Fibrous pseudotumor
Radiology images

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MRI: polycyclic mass

Clinical images

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Intrascrotal mass

Gross images

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Pedunculated mass

Well demarcated margins

Microscopic (histologic) images

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Dense fibrotic tissue

Collagen rich hyalinized fibrotic tissue

CD3

IgG4

CD31


Germ cell neoplasia in situ
Diagrams / tables

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GCNIS derived adult germ cell tumors

GCNIS derived adult germ cell tumors

Microscopic (histologic) images

Contributed by Stephanie Siegmund, M.D., Ph.D., Maria Tretiakova, M.D., Ph.D., Alexander Subtelny, M.D., Ph.D. and Michelle Hirsch, M.D., Ph.D.
Prominent, large atypical gonocytes Prominent, large atypical gonocytes Prominent, large atypical gonocytes

Prominent, large atypical gonocytes

Pagetoid GCNIS into rete testis Pagetoid GCNIS into rete testis

Pagetoid GCNIS into rete testis

Normal prepubertal testis

Normal prepubertal testis


GCNIS with adjacent microinvasion GCNIS with adjacent microinvasion

GCNIS with adjacent microinvasion

Podoplanin / D2-40

Podoplanin /
D2-40

Membranous D2-40 immunohistochemistry

Membranous
D2-40 IHC

Membranous KIT immunohistochemistry

Membranous KIT IHC

Nuclear OCT 3/4 immunohistochemistry

Nuclear OCT 3/4 IHC

Molecular / cytogenetics images

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Representative aneuploidy and chromosomal abnormalities

Representative aneuploidy and chromosomal abnormalities


Gonadoblastoma
Diagrams / tables

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Gonadoblastoma from UGT

Risk of developing a germ cell tumor

Radiology images

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CT, abdominal mass, gonadoblastoma

Clinical images
Not relevant
Gross images

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Gonadoblastoma and dysgerminoma in gonadal dysgenesis

Microscopic (histologic) images

Contributed by Brandon Douglas Metcalf, M.D.
Calcifications and tumor cell nests

Calcifications and tumor cell nests

Tumor cell nest

Tumor cell nest

Sex cord stromal cells

Sex cord stromal cells

Seminomatous germ cells

Seminomatous germ cells


OCT 3/4

OCT 3/4

SALL4

SALL4

Inhibin

Inhibin

FOXL2

FOXL2

Cytology images
Not relevant
Electron microscopy images

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Sertoli cells

Germ cells

Gonadoblastoma and Leydig cells

Leydig cells

Molecular / cytogenetics images

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Karyotype, mosaic of 45,X / 46,XY

Karyotype, mosaic of 45,X / 46,XY

Videos

Gonadoblastoma and digital pathology by Lewis Hassell, M.D.

Laparoscopic gonadectomy

Classification of ovarian lesions


Gonadoblastoma
Gross images

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Gonadoblastoma and dysgerminoma in gonadal dysgenesis

Microscopic (histologic) images

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Gonadoblastoma

Female patient


Granulomatous lesions of testis and paratestis
Gross images

Contributed by Yale Rosen, M.D. and @SueEPig on Twitter

TB orchitis

Granulomatous orchitis

Granulomatous orchitis



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Brucellosis

Microscopic (histologic) images

Contributed by Sean R. Williamson, M.D. and @SueEPig on Twitter

Tuberculosis involving testis and paratestis

Granulomatous orchitis Granulomatous orchitis Granulomatous orchitis

Granulomatous orchitis


Hernia sac with mesothelial entrapment
Microscopic (histologic) images

Contributed by Debra L. Zynger, M.D.

Entrapped glands

Cords, glands and small nests

Gland formation

Entrapped mesothelium

WT1

Calretinin


Hydrocele
Radiology images

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Scrotal MRI: cystic lesion

Encysted hydrocele

Gross images

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Abdominoscrotal hydrocele

Microscopic (histologic) images

Contributed by Francesca Sanguedolce, M.D., Ph.D.
Connective tissue, mild inflammation

Connective tissue, mild inflammation

Fibrosis, moderate inflammation

Fibrosis, moderate inflammation

Mesothelial lining

Mesothelial lining

Calretinin

Calretinin


Intratubular large cell hyalinizing Sertoli cell neoplasia (ITLCHSCN)
Microscopic (histologic) images

Contributed by Vikas Mehta, M.D.
Seminiferous tubules

Seminiferous tubules

Basement membrane deposition

Basement membrane deposition

Calretinin

Calretinin

Inhibin A

Inhibin A

Collagen IV

Collagen IV

PAS

PAS


Juvenile granulosa cell tumor
Radiology images

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Well encapsulated cystic mass

Well encapsulated cystic mass

Gross images

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Testicle after surgery

Testicle after surgery

Microscopic (histologic) images

Contributed by Vikas Mehta, M.D.
Variable sized follicles

Variable sized follicles

Follicles with bland cells

Follicles with bland cells

Tumor cells with eosinophilic cytoplasm

Tumor cells with eosinophilic cytoplasm

Round to oval hyperchromatic nuclei

Round to oval hyperchromatic nuclei


Large cell calcifying Sertoli cell tumor
Gross images

Contributed by Sara Vargas, M.D.
Ill defined testicular nodules

Ill defined testicular nodules



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Firm, white tan nodules

Tumor

Microscopic (histologic) images

Contributed by Stephanie Siegmund, M.D., Ph.D.
Calcifications, neutrophils, myxoid stroma

Calcifications, neutrophils, myxoid stroma

Focus of intratubular tumor

Focus of intratubular tumor

Tumor involving rete testis

Tumor involving rete testis

Mulberry calcifications

Mulberry calcifications

Trabecular architecture

Trabecular architecture


Focal nuclear pleomorphism

Focal nuclear pleomorphism

Neutrophilic infiltrate

Neutrophilic infiltrate

Minimal cytologic atypia

Minimal cytologic atypia

Mulberry calcifications

Mulberry calcifications

PRKAR1A loss by IHC

PRKAR1A loss


Leiomyosarcoma
Radiology images

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Mass posterior superior to right testis

Huge heterogeneous enhancing mass

Heterogenous echogenicity

Clinical images

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Ulcerated and
fungating tumor
involving scrotum

Gross images

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Well defined huge solid mass

Microscopic (histologic) images

Case #254

Various images

Vimentin


Desmin

Alpha smooth muscle actin

PAS

PLAP



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Pattern of spindle cells - H&E

Mitotic activity and atypical nuclei


Desmin+, SMA+

Desmin+

SMA+


Leydig cell tumor
Radiology images

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Missing Image

CT scan: circumscribed mass

Missing Image

MRI: solid enhancing mass

Missing Image

Ultrasound: mixed echogenic mass

Gross images

Contributed by Debra L. Zynger, M.D.
Small tumor

Small tumor

Nodular tumor

Nodular tumor

High risk tumor

High risk tumor



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Missing Image

Circumscribed brown tumor

Microscopic (histologic) images

Contributed by Manju Aron, M.D. and Kristine Cornejo, M.D.

Polygonal cells

Eosinophilic cells

Reinke crystals

Inhibin positive

SF1 positive


Liposarcoma
Diagrams / tables
N/A
Radiology images

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DDLPS CT abdomen / pelvis DDLPS CT abdomen / pelvis

DDLPS CT abdomen / pelvis

DDLPS CT abdomen / pelvis DDLPS CT abdomen / pelvis

DDLPS CT abdomen / pelvis

DDLPS CT abdomen / pelvis DDLPS CT abdomen / pelvis

DDLPS CT abdomen / pelvis


DDLPS scrotal ultrasound DDLPS scrotal ultrasound

DDLPS scrotal ultrasound

WDLPS CT pelvis

WDLPS CT pelvis

Nonhomogeneous right scrotal mass

Nonhomogeneous right scrotal mass

No evidence of tissue infiltration

No evidence of tissue infiltration

Clinical images

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Myxoid liposarcoma

Myxoid liposarcoma

Tumor after chemotherapy

Tumor after chemotherapy

Gross images

Contributed by Sara Moscovita Falzarano, M.D., Ph.D. and Debra L. Zynger, M.D.
Well differentiated liposarcoma

Well differentiated liposarcoma

Dedifferentiated liposarcoma

Dedifferentiated liposarcoma



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Well differentiated liposarcoma

Well differentiated liposarcoma

Dedifferentiated liposarcoma Dedifferentiated liposarcoma

Dedifferentiated liposarcoma

Dedifferentiated liposarcoma Dedifferentiated liposarcoma

Dedifferentiated liposarcoma

Microscopic (histologic) images

Contributed by Melanie Bourgeau, M.D.
Lipoma-like WDLPS

Lipoma-like WDLPS

WDLPS with ropey collagen

WDLPS with ropey collagen

Sclerotic WDLPS

Sclerotic WDLPS

Inflammatory WDLPS

Inflammatory WDLPS

Low grade DDLPS, fibromatosis pattern

Low grade DDLPS, fibromatosis pattern

Low grade DDLPS, whorling pattern

Low grade DDLPS, whorling pattern


Low grade DDLPS, storiform pattern

Low grade DDLPS, storiform pattern

Low grade DDLPS, myogenic differentiation

Low grade DDLPS, myogenic differentiation

Low grade DDLPS, metaplastic

Low grade DDLPS, metaplastic

High grade DDLPS, myxofibrosarcoma pattern

High grade DDLPS, myxofibrosarcoma pattern

High grade DDLPS, pleomorphic pattern

High grade DDLPS, pleomorphic pattern

High grade DDLPS, ectatic vessels

High grade DDLPS, ectatic vessels


High grade DDLPS, inflammatory pattern

High grade DDLPS, inflammatory pattern

High grade DDLPS, homologous differentiation

High grade DDLPS, homologous differentiation

Myxoid liposarcoma, low grade

Myxoid liposarcoma, low grade

Myxoid liposarcoma, high grade

Myxoid liposarcoma, high grade

Pleomorphic liposarcoma

Pleomorphic liposarcoma

Pleomorphic liposarcoma, epithelioid subtype

Pleomorphic liposarcoma, epithelioid subtype

Cytology images
N/A
Electron microscopy images
N/A
Molecular / cytogenetics images
N/A
Videos

Liposarcoma (general overview)

Well differentiated liposarcoma

Dedifferentiated liposarcoma

Dedifferentiated liposarcoma with osteosarcomatous differentiation


Myxoid liposarcoma, low grade

Myxoid liposarcoma, high grade

Pleomorphic liposarcoma

Pleomorphic liposarcoma, epithelioid variant


Liposarcoma
Radiology images

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Nonhomogeneous right scrotal mass

No evidence of tissue infiltration

Large heterogenous extratesticular mass

CT of paratesticular liposarcoma presenting as hernia

Clinical images

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Scrotal mass at presentation

Tumor after chemotherapy

Gross images

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Tumor mass

Yellow and myxoid areas

White yellow to red brown cut surface, marked necrosis

Right paratesticular mass with solid, yellow white, fatty, myxoid areas

Grossly firm tumor

Microscopic (histologic) images

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Well differentiated liposarcoma:

Atypical spindle cells and lipoblasts

Mature adipocytes and lipoblasts



Well differentiated with dedifferentiated component:

Hypercellular stroma with atypical adipocytes

Atypical adipocytes with enlarged nuclei



Dedifferentiated with leiomyosarcomatous component:

H&E

MDM2+, CDK4+, alpha smooth muscle actin+, desmin+



Myxoid liposarcoma:

Lipoblasts contain lipid vacuoles

Plexiform arrangement of capillaries


Melanotic neuroectodermal tumor
Gross images

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Maxillary tumors

Microscopic (histologic) images

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Maxillary tumor: H&E and stains


Mesothelioma
Radiology images

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Increased thickness of the left tunica vaginalis

Small nodules

Border indistinctness in the right scrotum

Clinical images

Case #261

Gross images

AFIP images

Tunica vaginalis



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Radical orchiectomy specimen

Nodular mass at spermatic cord

Extracted tumor adhered strongly to scrotum skin

Microscopic (histologic) images

Contributed by Jennifer Gordetsky, M.D.
Malignant mesothelioma Mesothelioma

Mesothelioma



Case #261



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Epithelial tumor cells

Glandular pattern in desmoplastic stroma

Malignant mesothelial tubular structures

Biphasic exophytic nodule


Papillary structures

Mesothelioma of uncertain malignant potential

Cells are rounded with nuclear atypia


Metastases
Radiology images

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Renal cell carcinoma metastasis to testis

Lung adenocarcinoma metastasis to testis

Colorectal adenocarcinoma metastasis to testis

Gross images

Contributed by Debra L. Zynger, M.D.
Metastatic prostatic adenocarcinoma

Metastatic prostatic adenocarcinoma



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Metastatic colorectal adenocarcinoma

Metastatic renal cell carcinoma

Microscopic (histologic) images

Contributed by Gang Wang, M.D., Ph.D.

Metastatic prostatic adenocarcinoma
Missing Image

Involvement of the tubular system

Missing Image

Cribriform pattern
most frequent,
epididymis
involvement

Missing Image

Solid growth pattern

Missing Image

Metastatic ductal adenocarcinoma

Missing Image

Positive for PSA

Missing Image

Positive for ERG



Metastatic renal cell carcinoma, clear cell type
Missing Image

Broad pushing borders

Missing Image

Mixed patterns

Missing Image

Positive for PAX8

Missing Image

Positive for CAIX

Metastatic colorectal
adenocarcinoma

Missing Image

Cystic spaces containing mucin

Metastatic cutaneous squamous
cell carcinoma

Missing Image

Infiltrating and anastomosing nests

Missing Image

Positive for p40


Mixed and other sex cord stromal tumors
Gross images

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Well circumscribed lower pole testicular tumor

Microscopic (histologic) images

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Tumor is compressing adjacent tunica

Fascicular and storiform spindle cell arrangement

Insular arrangement of cells in hyaline stroma

Irregular ovoid nuclei with longitudinal grooves


Mucinous borderline tumor
Clinical images

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Area of curvilinear calcification

Microscopic (histologic) images

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Various images


Mucinous cystadenocarcinoma
Clinical images

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Right testicular borderline mucinous tumor

Microscopic (histologic) images

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Cyst wall irregularly thickened and fibrotic

Mucinous epithelium
resembling endocervical
type cells


Myoid gonadal stromal tumor
Radiology images

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Ultrasound features

Microscopic (histologic) images

Contributed by Vikas Mehta, M.D.

Ectatic blood vessels

Spindle arrangement of tumor cells


SF1 positivity

h-caldesmon negativity

SMA positivity

S100 positivity


Papillary cystadenoma
Clinical images

Images hosted on other servers:

Complex echo pattern

Gross images

Images hosted on other servers:

Epididymal tumor

Microcystic with hemorrhage

Microscopic (histologic) images

Images hosted on other servers:

Cystic space with papillary excrescences

Cilia

Case with clear cells

CK7

CD10


Polyembryoma
Gross images

Contributed by Delia Perez-Montiel, M.D.

40 year old man

Microscopic (histologic) images

Contributed by Delia Perez-Montiel, M.D.




Proliferative funiculitis
Diagrams / tables
N/A
Radiology images

Images hosted on other servers:
Ultrasonographic, T2 weighted MR and CT scan images

Ultrasonographic, T2 weighted MR and CT scan images

Scrotal ultrasound and MR images Fibrous pseudotumor of the scrotum

Scrotal ultrasound and MR images

Clinical images

Images hosted on other servers:
Multiple paratesticular polypoid masses

Multiple paratesticular polypoid masses

Multiple polypoid tunica vaginalis masses

Multiple polypoid tunica vaginalis masses

Multiple tunica vaginalis nodules

Multiple tunica vaginalis nodules

Gross images

Images hosted on other servers:
Multiple polypoid tunica vaginalis masses

Multiple polypoid tunica vaginalis masses

Well demarcated tan-yellow lesion

Well demarcated tan-yellow lesion

Tumor in undescended testis

Tumor in undescended testis

Microscopic (histologic) images

Contributed by Veronica Ulici, M.D., Ph.D.
Ill defined fibrous lesion

Ill defined fibrous lesion

Paucicellular fibrous lesion

Paucicellular fibrous lesion

Bland fibroblasts and myofibroblasts

Bland fibroblasts and myofibroblasts

Focal calcifications

Focal calcifications


Mixed inflammatory infiltrate

Mixed inflammatory infiltrate

Prominent chronic inflammation

Prominent chronic inflammation

Ganglion-like cells

Ganglion-like cells

Cytology images
N/A
Electron microscopy images

Images hosted on other servers:
Spindle cell in collagenous stroma

Spindle cell in collagenous stroma

Molecular / cytogenetics images
N/A
Videos

Paratesticular fibrous pseudotumor
pathology mini tutorial


Proliferative funiculitis
Gross images

Images hosted on other servers:

Tumor in undescended testis

Microscopic (histologic) images

Images hosted on other servers:

Spindle cell proliferation


Regressed germ cell tumor
Radiology images

Images hosted on other servers:

Scrotal ultrasound

Regressed
primary with
retroperitoneal
metastasis

Gross images

Contributed by Debra L. Zynger, M.D.

Complete regression (pT0)

Germ cell neoplasia in situ only (pTis)

Partial regression (pT1)

Microscopic (histologic) images

Contributed by Debra L. Zynger, M.D.

Scar

Acellular matrix

Small vessels

Hemosiderin


Germ cell neoplasia in situ

OCT3 / 4

D2-40

CD117


Seminoma
Radiology images

Images hosted on other servers:
Missing Image

Ultrasound with testicle mass

Missing Image

Parietal metastasis

Gross images

Contributed by Debra L. Zynger, M.D.
Missing Image

pT1a

Missing Image

pT1b

Missing Image

pT2



Images hosted on other servers:
Missing Image

Very large seminoma

Missing Image

Seminoma

Missing Image

Lobulated soft tan to brown tissue

Microscopic (histologic) images

Contributed by Michelle Downes, M.D. and Debra L. Zynger, M.D.
Missing Image

Fibrous septae

Missing Image

Admixed lymphocytes

Missing Image

Large cells with clear cytoplasm

Missing Image

Coagulative necrosis

Missing Image

OCT 3/4

Missing Image

CD117


Missing Image

Granulomatous inflammation

Missing Image

Granuloma

Missing Image

Intratubular seminoma

Missing Image

Rete testis invasion

Missing Image

Rete testis pagetoid spread

Missing Image

Hilar fat invasion


Missing Image

Epididymal invasion

Missing Image

Syncytiotrophoblasts

Missing Image

hCG

Missing Image Missing Image

Discontinuous spermatic cord invasion

Cytology images

Contributed by Michelle Downes, M.D. and Debra L. Zynger, M.D.
Missing Image

Intraoperative touch prep

Missing Image

Large cells with prominent nucleoli

Missing Image

Tigroid pattern


Serous cystadenocarcinoma
Gross images

Images hosted on other servers:

Intratesticular mass

Microscopic (histologic) images

Images hosted on other servers:
Missing Image

WT1+


Sertoli cell nodule
Radiology images

Contributed by Raman Danrad, M.D.
Ultrasound of left testis

Ultrasound of left testis

Gross images

Images hosted on other servers:
Demarcated, bulging, pale yellowish nodules

Demarcated, bulging, pale yellowish nodules

Sharply demarcated, yellowish white nodule

Sharply demarcated, yellowish white nodule

Microscopic (histologic) images

Contributed by Ritu Bhalla, M.D. and Jian-Hua Qiao, M.D.
Unencapsulated nodule

Unencapsulated nodule

Seminiferous tubule proliferation

Seminiferous tubule proliferation

Focal Leydig cells

Focal Leydig cells

Hyaline basement membrane deposits

Hyaline basement membrane deposits

Pseudostratified Sertoli cells

Pseudostratified Sertoli cells

Arrangement of Sertoli cells

Arrangement of Sertoli cells


Calcification

Calcification

Hyperplastic Sertoli cells

Hyperplastic Sertoli cells

Atrophic seminiferous tubules

Atrophic seminiferous tubules

Persistent immature tubules

Persistent immature tubules

Hyalinization of basement membrane

Hyalinization of basement membrane

Atrophic seminiferous tubules

Atrophic seminiferous tubules

Electron microscopy images

Images hosted on other servers:
Thickened, multilamellar basement membranes

Thickened, multilamellar basement membranes

Hyaline core

Hyaline core


Sertoli cell only
Microscopic (histologic) images

Contributed by Asmaa Gaber Abdou, M.D.

Sertoli cell only and Leydig cell hyperplasia


Sertoli cell tumor
Radiology images

Images hosted on other servers:
Hypoechoic lesion

Hypoechoic lesion

Gross images

Images hosted on other servers:
Tumor in lower pole

Tumor in lower pole

Microscopic (histologic) images

Contributed by Thomas Ulbright, M.D. and Case #18

Architectural patterns
Cords

Cords

Tubules

Tubules

Tubopapillary

Tubopapillary

Macrocystic

Macrocystic

Microcystic Microcystic

Microcystic



Architectural patterns
Whorled

Whorled

Trabecular

Trabecular


Sclerosing Sertoli cell tumor

Various images



Cells
Abundant clear cytoplasm (most common)

Abundant clear cytoplasm (most common)

Heavily lipidized

Heavily lipidized


Malignant
Marked cytologic atypia

Marked cytologic atypia

Tumor necrosis

Tumor necrosis

Lymphovascular invasion

Lymphovascular invasion

High N/C ratio, increased mitotic / apoptic activity

High N/C ratio,
increased
mitotic / apoptotic
activity

Cytology images

Contributed by Indiana University School of Medicine
Tubular formations, monotonous small cells (Pap)

Tubular formations, monotonous small cells (Pap)

Papillary groups and dyscohesive cells (Pap)

Papillary groups and discohesive cells (Pap)


Smooth muscle hyperplasia
Gross images

Images hosted on other servers:

Well circumscribed multicystic mass

Microscopic (histologic) images

Images hosted on other servers:

Columnar epididymal type epithelium

Cystic duct

Mass blends with ducts in epididymal tail


Spermatocele
Radiology images

Images hosted on other servers:
Ultrasound images Ultrasound images Ultrasound images

Ultrasound images

Gross images

Contributed by Anil Parwani, M.D., Ph.D., M.B.A.
Orchiectomy with spermatocele

Orchiectomy
with spermatocele

Microscopic (histologic) images

Contributed by Anil Parwani, M.D., Ph.D., M.B.A.
Spermatocele with adjacent epididymis

Spermatocele with adjacent epididymis

Cuboidal epithelium

Cuboidal epithelium

Ciliated columnar epithelium

Ciliated columnar epithelium

Flattened epithelium

Flattened epithelium

Aggregate of spermatozoa

Aggregate of spermatozoa

Macrophages containing spermatozoa

Macrophages containing spermatozoa


Spermatocytic tumor
Radiology images

Images hosted on other servers:
ST (arrow) and testis (*)

ST (arrow) and testis (*)

Gross images

AFIP images

Mucoid tumor



Images hosted on other servers:
ST (arrow)

ST (arrow)

Cystic and mucoid tumor

Microscopic (histologic) images

Contributed by Maurizio Colecchia, M.D., Case #448 and AFIP images
Lobulated architecture

Lobulated architecture

Tripartite cytology

Tripartite cytology

Prevalent intermediate sized cells

Prevalent intermediate sized cells

Mitoses and apoptotic bodies

Mitoses and apoptotic bodies

Short fibrous bands

Short fibrous bands

Spireme-like chromatin

Spireme-like chromatin


Edema and microcysts

Edema and microcysts

Edema and nests

Edema and nests

Intratubular growth

OCT3/4

OCT3/4

CD45

CD45


Diffuse growth pattern

Focal pseudoglandular pattern

Cystic pattern

Polymorphic cell population

Small nests, trabeculae, clusters and single cells



Filamentous chromatin

Normal spermatogenesis

Unusual features

Desmin+

Tumor nests and
cords mixed with
lymphocytes

Prominent
granulomatous
reaction and
lymphoid infiltrate

Intratubular component

Electron microscopy images

AFIP images

Intercellular bridge

Nest of spermatocytic seminoma


Splenogonadal fusion
Microscopic (histologic) images

Case #309

Staging
Gross images

Contributed by Debra L. Zynger, M.D.

Complete regression (pT0)

Germ cell neoplasia in situ only (pTis)

Partial regression (pT1)

Teratoma (pT1)

Teratoma and EC (pT1)

Seminoma (pT1a)


Seminoma (pT1b)

Mixed germ cell tumor (pT2)

Seminoma (pT2)

No residual testis tumor (ypT0)


No residual node tumor (ypN0)

Lymph node with residual tumor (ypN1 - 3)

Discontinuous spermatic cord (pM1)

Microscopic (histologic) images

Contributed by Debra L. Zynger, M.D.

Lymphovascular invasion (pT2)

Lymphovascular invasion (pT2)

Tunica vaginalis invasion (pT2)


Epididymal invasion (pT2)

Hilar soft tissue invasion (pT2)

Lymph node metastasis (pN1)

Post treatment node (ypN0)

Post treatment node (ypN1)


Discontinuous spermatic cord invasion (pM1)


Teratoma
Radiology images

Images hosted on other servers:

Testicular teratoma diagnosed in utero

Demonstrating vascularity of testicular teratoma with calcifications

Gross images

Contributed by Debra L. Zynger, M.D.

Teratoma (100%)

Mixed GCT

Microscopic (histologic) images

Contributed by Debra L. Zynger, M.D.

Cartilage surrounded by mitotically active spindle cells

Gastrointestinal epithelium

Squamous epithelium

Cellular mesenchyme

Loose mesenchyme

Neuroectoderm


Teratoma with somatic type malignancy
Gross images

Contributed by Christopher Dall, M.D. and Debra L. Zynger, M.D.
Missing Image

Retroperitoneal sarcoma, NOS

Missing Image

Lung rhabdo-
myosarcoma

Missing Image

Iliac leiomyosarcoma

Missing Image

Embryonic type neuroectodermal tumor

Microscopic (histologic) images

Contributed by Christopher Dall, M.D. and Debra L. Zynger, M.D.
Missing Image Missing Image

Metastatic rhabdomyosarcoma

Missing Image Missing Image

Metastatic chondrosarcoma


Missing Image Missing Image

Metastatic sarcoma, NOS

Missing Image Missing Image

Embryonic type neuroectodermal tumor within testis


Teratoma-neuroendocrine tumor
Gross images

AFIP images
Testicular NET

Solid tan mass

Microscopic (histologic) images

Contributed by Sounak Gupta, M.B.B.S, Ph.D. and Rafael E. Jimenez, M.D.
Epidermoid cyst and NET Epidermoid cyst and NET

Epidermoid cyst and NET

Retraction artifact

Retraction artifact

Multiple solid nests

Multiple solid nests

Insular growth pattern

Insular growth pattern

Nests of tumor cells

Nests of tumor cells

Videos

Testicular NET


Testicular adrenal rest tumor / tumor of adrenogenital syndrome
Clinical images

Images hosted on other servers:

Dexamethasone treatment

Large TTAGS

Gross images

Images hosted on other servers:

Well circumscribed,
noncapsulated, solid
and lobulated brown lesion

Microscopic (histologic) images

Images hosted on other servers:

H&E

H&E, IHC, CD56

H&E


Testicular regression syndrome / anorchia
Microscopic (histologic) images

Torsion
Diagrams / tables

Images hosted on other servers:
Bell clapper deformity leading to intravaginal testicular torsion

Bell clapper deformity
leading to intravaginal
testicular torsion

Radiology images

Contributed by Raman Danrad, M.D.
Ultrasound of bilateral testis

Ultrasound of bilateral testis

Ultrasound of right normal testis

Ultrasound of right normal testis

Ultrasound of left torsed testis

Ultrasound of left torsed testis

Clinical images

Images hosted on other servers:
Twisting of spermatic cord

Twisting of spermatic cord

Gross images

Images hosted on other servers:
Smooth external surface of torsed testis

Smooth external surface of torsed testis

Dark red hemorrhagic cut surface

Dark red hemorrhagic cut surface

Microscopic (histologic) images

Contributed by Ritu Bhalla, M.D.
Congestion

Congestion

Hilar hemorrhage

Hilar hemorrhage

Sloughing of cells

Sloughing of cells

Interstitial hemorrhage

Interstitial hemorrhage


Residual germ cells

Residual germ cells

Infarcted tubules

Infarcted tubules

Necrotic parenchyma

Necrotic parenchyma


Varicocele
Radiology images

Images hosted on other servers:

Left sided grade 3 varicocele

Color Doppler ultrasonography of varicocele

Microscopic (histologic) images

Contributed by Kenneth A. Iczkowski, M.D.

Orchiectomy specimen in a 30 year old with atrophic testis and varicocele


Vasculitis
Radiology images

Case #328

Testicular heterogeneous hypoechoic lesion

Gross images

Case #328
Microscopic (histologic) images

Case #328



Vasitis nodosa
Microscopic (histologic) images

Images hosted on other servers:

Vasitis nodosa


Well differentiated papillary mesothelial tumor
Microscopic (histologic) images

Contributed by Aida Valencia, M.D. and Jennifer Gordetsky, M.D.
Numerous fibrovascular cores Numerous fibrovascular cores

Numerous fibrovascular cores

Background macrophages

Background macrophages

Broad papillae Broad papillae

Broad papillae


Papillae with myxoid stroma Papillae with myxoid stroma

Papillae with myxoid stroma

Nonpsammomatous calcifications Nonpsammomatous calcifications

Nonpsammomatous calcifications

Calretinin

Calretinin


WT1 immunostain WT1 immunostain

WT1

D2-40

D2-40

Malignant mesothelioma Mesothelioma

Mesothelioma

Molecular / cytogenetics images

Images hosted on other servers:

TRAF7 and CDC42 somatic mutations


Yolk sac tumor
Gross images

Contributed by Debra L. Zynger, M.D.
Mixed germ cell tumor, postpubertal with varying % of yolk sac tumor Mixed germ cell tumor, postpubertal with varying % of yolk sac tumor Mixed germ cell tumor, postpubertal with varying % of yolk sac tumor

Mixed germ cell tumor, postpubertal with varying % of yolk sac tumor

Microscopic (histologic) images

Contributed by João Lobo, M.D. and Rui Henrique, M.D., Ph.D.
Microcystic pattern Microcystic pattern

Microcystic pattern

Hyaline globules Hyaline globules

Hyaline globules

Glandular pattern Glandular pattern

Glandular pattern


Schiller-Duval bodies Schiller-Duval bodies Schiller-Duval bodies

Schiller-Duval bodies

Metastasis Metastasis

Metastasis

Back to top
Recent Testis & paratestis Pathology books

Amin: 2022

Behnke: 2018

Cheng: 2019

Colecchia : 2016

IARC: 2022

Manuel: 2019

Nistal: 2017

Ulbright: 2022

VandenBussche: 2022

Wobker: 2021

Yang: 2020

Zhou: 2022

Zhou: 2022



Find related Pathology books: GU/adrenal, cytopathology
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