Pathology of tumours of the male genital tract

The most common neoplasms of the male genital tract are tumours of the testis and prostate. Testicular germ cell tumours are particularly important because they affect young men and even the advanced stages have a high rate of cure. The WHO classification emphasizes the recognition of seminoma and individual non-seminomatous germ cell tumour patterns. Included in this group are the embryonal carcinoma, yolk sac tumour, trophoblastic tumour and teratoma. Many of the tumours are combined, containing more than one tumour component. It is important to differentiate between embryonal carcinoma and a high-grade variant of seminoma, or distinguish a malignant change in a teratomatous deposit from one of the patterns of high-grade germ cell tumours. The WHO classification also emphasizes the recognition of various yolk sac tumour patterns. Non-germ cell tumours of testis are uncommon, but it is important to recognize sex cord stromal tumours and differentiate them from germ cell tumours. The sex cord stromal tumours include Leydig cell tumours, Sertoli cell tumours, Granulosa cell tumours and tumours of the the coma/fibroma group. Malignant lymphoma is the most common amongst haematopoietic tumours occurring in the testis. Prostate cancer is the most common malignancy in elderly men in the UK. The use of needle biopsy of prostate has improved early diagnosis, but creates difficulty in interpretation. High-grade prostate intraepithelial neoplasia is a clinically significant finding requiring intervention. Prostate adenocarcinoma is graded by the Gleason scoring system.