FIGURE 16.1

Testis ultrasound with power Doppler angiogram showing a well-defined low echo mass with increased blood flow, suggesting a well-vascularized tumour.

FIGURE 16.2

Orchidectomy specimen with most of the testis replaced by a solid tumour which is partly necrotic and haemorrhagic. Choriocarcinomas (malignant teratoma trophoblastic, MTT) are typically haemorrhagic.

FIGURE 16.3

Choriocarcinoma (MTT) with multinuclear syncytiotrophoblast and cytotrophoblast cells. These cells can be shown to contain human chorionic gonadotrophin (hCG) by immunohistochemistry.

FIGURE 16.4

Seminoma of the testis. Lobulated, creamy white tumour replaces most of the body of the testis, but there is no necrosis.

FIGURE 16.5

Seminoma of the testis. Tumour cells at the periphery have clear cytoplasm and well-demarcated cell borders. Centrally, there is a lymphoid follicle; this is a common occurrence in these tumours.

FIGURE 16.6

Malignant teratoma of testis with extensive haemorrhagic necrosis.

FIGURE 16.7

Embryonal carcinoma – the most common malignant element seen in malignant teratomas. The tumour cells have an epithelial (carcinomatous) appearance.

FIGURE 16.8

Benign nodular hyperplasia of the prostate. Hypertrophy of the central portion of the gland (middle lobe) projects into the base of the bladder. Obstruction of urinary flow has produced hypertrophy of muscle of bladder wall, giving this trabeculated appearance and also a degree of ureteric dilatation and hydronephrosis.

FIGURE 16.9

Carcinoma of prostate gland, seen in a needle biopsy. The tumour can be seen encircling a nerve in the centre.

FIGURE 16.10

Carcinoma of prostate gland in radical prostatectomy specimen. The tumour occupies most of gland on the left of the picture.

FIGURE 16.11

Osteosclerotic (osteoblastic) metastasis of carcinoma of prostate gland in a vertebral body.

FIGURE 16.12

Anteroposterior (A) and lateral (B) radiographs of the lumbar spine of the patient. The bodies and posterior elements of L2, L5 and S1 vertebrae are sclerotic. There are also areas of patchy sclerosis in other vertebral bodies and in the right iliac bone. This is the typical appearance of skeletal metastases from prostate cancer.

FIGURE 16.13

Needle core biopsy of prostate: (A) low power; (B) high power This is a well-differentiated adenocarcinoma, which is subtly different from normal in its diffuse non-lobular pattern of growth, and glands lined by single layers of cells with prominent nucleoli.

FIGURE 16.14

Carcinoma of the penis, arising beneath the prepuce and destroying much of the glans.