testicular patho

[shisha]

Daniel, a 25 yrs old male, presents with a mass in his right testis which upon examination was found to be made up of polygonal cells with clear cytoplasm and round nuclei.They are surrounded by a lot of fibrous stroma.You want to look for a marker to make the diagnosis. Which of the following tumor markers should be raised in this patient?

A]prostatic specific antigen
B]placental alkaline phosphatase
C]Alpha feto protein
D]both B HCG and alpha feto protein

[shisha]

B]Placental alkaline phosphatase:correct answer
The polygonal cells with clear cytoplasm in lobules and surrounded by fibrous is the feature of the most common testicular cancer "Seminoma"....in which the placental alkaline phosphate is increased.

A]PSA is increased in prostate ca

C]AFP is increased in embryonal ca or yolk sac tumor of testis

D]HCGincreased in chorio ca of testis

[nafees ahmad]

i seminoma HCG CAN ALSO BE RAISED

[stephew]

and in real life you ALWAYS. A-L-W-A-Y-S rule out nonseminomatous component by ordering AFP. if its positive you assume there is a nons component and treat as such. or you are big trouble.

[stephew]

also PAP may be rasied but it may not and it doesnt tell you much if it is. the important thing is being AFP negative.

[hunteradam07]

there is a similiar question to this in UW but has thyroid component to it. Since HCG is analog to TRH, LH, and FSH that is why u will have thyroidism related to HCG. However, since this question doesnt have any thyroid component to it, i will go with AFP.