Difference between revisions of "Mixed germ cell tumour"

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| IF        =
| IF        =
| Gross      = heterogeneous appearance, typically solid and cystic
| Gross      = heterogeneous appearance, typically solid and cystic
| Grossing  = [[orchiectomy]]
| Grossing  = [[orchiectomy grossing]]
| Staging    = [[testicular cancer staging]]
| Site      = [[ovary]], [[testis]], [[mediastinum]], other
| Site      = [[ovary]], [[testis]], [[mediastinum]], other
| Assdx      =
| Assdx      =
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| Symptoms  =
| Symptoms  =
| Prevalence = most common germ cell tumour
| Prevalence = most common germ cell tumour
| Bloodwork  = +/-AFP elevated, +/-beta-hCG elevated, +/-LDH elevated
| Bloodwork  = +/-[[AFP]] elevated, +/-beta-hCG elevated, +/-LDH elevated
| Rads      =
| Rads      =
| Endoscopy  =
| Endoscopy  =
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*Heterogeneous appearance - distinctive regions that look different from one another.
*Heterogeneous appearance - distinctive regions that look different from one another.
*Typically solid and cystic.
*Typically solid and cystic.
===Images===
<gallery>
Image:Mixed_Germ_Cell_Tumor_of_Testis_(3260625567).jpg | Mixed germ cell tumour. (WC/euthman)
</gallery>


==Microscopic==
==Microscopic==
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==IHC==
==IHC==
*Immunostains are useful for differentiating components, e.g. [[yolk sac tumour]] versus [[embryonal carcinoma]].
Looking for elements
*Beta-hCG +ve - if syncytiotrophoblasts are present.
*Beta-hCG +ve - if syncytiotrophoblasts are present.
*AFP +ve - a yolk sac tumour component is present.
*[[AFP]] +ve (or Glypican 3 +ve) - a yolk sac tumour component is present.
*GFAP +ve - if neuroepithelium is present.
*GFAP +ve - if neuroepithelium is present.


A panel:
A panel:
*PLAP.
*CD30 +ve -- [[embryonal carcinoma]].
*CD30 +ve -- [[embryonal carcinoma]].
*CD117 +ve -- [[seminoma]].
*OCT4 +ve -- [[seminoma]].
*D2-40 +ve -- seminoma, useful for [[LVI]].
*D2-40 +ve -- seminoma, useful for [[LVI]].
*Pankeratin +ve -- embryonal carcinoma.
*[[Pankeratin]] +ve -- embryonal carcinoma.
*CEA-M.
*CEA-M.
*EMA +ve -- metastatic carcinoma.<ref>{{Cite journal  | last1 = Shek | first1 = TW. | last2 = Yuen | first2 = ST. | last3 = Luk | first3 = IS. | last4 = Wong | first4 = MP. | title = Germ cell tumour as a diagnostic pitfall of metastatic carcinoma. | journal = J Clin Pathol | volume = 49 | issue = 3 | pages = 223-5 | month = Mar | year = 1996 | doi =  | PMID = 8675733 }}</ref>
*[[EMA]] +ve -- metastatic carcinoma.<ref>{{Cite journal  | last1 = Shek | first1 = TW. | last2 = Yuen | first2 = ST. | last3 = Luk | first3 = IS. | last4 = Wong | first4 = MP. | title = Germ cell tumour as a diagnostic pitfall of metastatic carcinoma. | journal = J Clin Pathol | volume = 49 | issue = 3 | pages = 223-5 | month = Mar | year = 1996 | doi =  | PMID = 8675733 }}</ref>
*Vimentin.
*[[Vimentin]].
*AFP +ve -- [[yolk sac tumour]].
*[[Glypican 3]] +ve -- [[yolk sac tumour]].
*A1A +ve -- yolk sac tumour.
**Others: A1A +ve -- yolk sac tumour, AFP +ve -- yolk sac tumour.


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