Difference between revisions of "Leydig cell tumour"

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| Symptoms  =
| Symptoms  =
| Prevalence = uncommon
| Prevalence = uncommon
| Bloodwork  = +/-elevated testosterone
| Bloodwork  = +/-elevated testosterone (rarely elevated estradiol)
| Rads      =
| Rads      =
| Endoscopy  =
| Endoscopy  =
| Prognosis  = benign
| Prognosis  = usu. benign
| Other      =
| Other      =
| ClinDDx    = other testicular tumours
| ClinDDx    = other testicular tumours
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*Arises from the interstitial cell.
*Arises from the interstitial cell.
*May be associated with increased testosterone.
*May be associated with increased testosterone.
*Can be malignant in adults.<ref name=pmid17284120>{{Cite journal  | last1 = Al-Agha | first1 = OM. | last2 = Axiotis | first2 = CA. | title = An in-depth look at Leydig cell tumor of the testis. | journal = Arch Pathol Lab Med | volume = 131 | issue = 2 | pages = 311-7 | month = Feb | year = 2007 | doi = 10.1043/1543-2165(2007)131[311:AILALC]2.0.CO;2 | PMID = 17284120 | URL = http://www.archivesofpathology.org/doi/full/10.1043/1543-2165%282007%29131%5B311:AILALC%5D2.0.CO;2 }}</ref>


Clinical:<ref name=pmid17284120/>
*+/-Elevated testosterone.
**Rarely elevated estradiol.
*ACTH low.
==Gross==
==Gross==
*Solid, lobulated.
*Solid, lobulated.
*Red/tan.
*Red/tan.
*Typically 3-5 cm.<ref name=pmid17284120/>


Image:
Image:
Line 47: Line 53:
*Vacuolization (cytoplasm) - '''key feature'''.
*Vacuolization (cytoplasm) - '''key feature'''.
*Cytoplasm - clear to eosinophilic - '''important'''.
*Cytoplasm - clear to eosinophilic - '''important'''.
**Usually eosinophilic.
*''Reinke crystals'' - classic finding, usually not present.
*''Reinke crystals'' - classic finding, usually not present.
**Cylindrical crystalloid eosinophilic cytoplasmic bodies.
**Cylindrical crystalloid eosinophilic cytoplasmic bodies.
Line 55: Line 62:
*[[Spermatocytic seminoma]] - may have eosinophilic cytoplasm.
*[[Spermatocytic seminoma]] - may have eosinophilic cytoplasm.
*[[Pregnancy luteoma]] - occurs during pregnancy, as the name implies.
*[[Pregnancy luteoma]] - occurs during pregnancy, as the name implies.
*Leydig cell hyperplasia.
*[[Granular cell tumour]].<ref name=pmid17284120/>


===Images===
===Images===

Revision as of 04:25, 18 November 2013

Leydig cell tumour
Diagnosis in short

Leydig cell tumour. H&E stain.

LM cytoplasmic vacuolization, cytoplasm -- clear to eosinophilic, +/-Reinke crystals (cylindrical crystalloid -- eosinophilic cytoplasmic bodies), +/-nucleoli common, round nuclei
LM DDx spermatocytic seminoma (testis only), pregnancy luteoma (females only), Sertoli-Leydig cell tumour
IHC inhibin-alpha +ve, calretinin +ve, melan A +ve
Gross solid, red/tan
Site testis

Prevalence uncommon
Blood work +/-elevated testosterone (rarely elevated estradiol)
Prognosis usu. benign
Clin. DDx other testicular tumours

Leydig cell tumour, also known as interstitial cell tumour, is an uncommon benign sex cord-stromal tumour, typically seen in the testis.

Interstitial cell tumour should not be confused with renomedullary interstitial cell tumour.

General

  • Arises from the interstitial cell.
  • May be associated with increased testosterone.
  • Can be malignant in adults.[1]

Clinical:[1]

  • +/-Elevated testosterone.
    • Rarely elevated estradiol.
  • ACTH low.

Gross

  • Solid, lobulated.
  • Red/tan.
  • Typically 3-5 cm.[1]

Image:

Microscopic

Features:[2]

  • Vacuolization (cytoplasm) - key feature.
  • Cytoplasm - clear to eosinophilic - important.
    • Usually eosinophilic.
  • Reinke crystals - classic finding, usually not present.
    • Cylindrical crystalloid eosinophilic cytoplasmic bodies.
  • Nucleoli common.
  • Round nuclei.

DDx:

Images

www:

IHC

See also

References

  1. 1.0 1.1 1.2 1.3 Al-Agha, OM.; Axiotis, CA. (Feb 2007). "An in-depth look at Leydig cell tumor of the testis.". Arch Pathol Lab Med 131 (2): 311-7. doi:10.1043/1543-2165(2007)131[311:AILALC]2.0.CO;2. PMID 17284120.
  2. Zhou, Ming; Magi-Galluzzi, Cristina (2006). Genitourinary Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 581. ISBN 978-0443066771.
  3. URL: http://www.antibodybeyond.com/reviews/cell-markers/leydig-cell-marker.htm. Accessed on: 18 May 2010.
  4. Bar-Shira Maymon B, Yavetz H, Yogev L, et al. (2005). "Detection of calretinin expression in abnormal immature Sertoli cells in non-obstructive azoospermia". Acta Histochem. 107 (2): 105–12. doi:10.1016/j.acthis.2005.02.002. PMID 15950053.
  5. Yao DX, Soslow RA, Hedvat CV, Leitao M, Baergen RN (September 2003). "Melan-A (A103) and inhibin expression in ovarian neoplasms". Appl. Immunohistochem. Mol. Morphol. 11 (3): 244–9. PMID 12966351.