Difference between revisions of "Embryonal carcinoma"

From Libre Pathology
Jump to navigation Jump to search
Line 72: Line 72:


==IHC==
==IHC==
[[ISUP]] consensus paper by Ulbright ''et al.'':<ref name=pmid24832161>{{cite journal |author=Ulbright TM, Tickoo SK, Berney DM, Srigley JR |title=Best practices recommendations in the application of immunohistochemistry in testicular tumors: report from the international society of urological pathology consensus conference |journal=Am. J. Surg. Pathol. |volume=38 |issue=8 |pages=e50–9 |year=2014 |month=August |pmid=24832161 |doi=10.1097/PAS.0000000000000233 |url=}}</ref>
*OCT4 +ve.
**Choriocarcinoma, yolk sac tumour and spermatocytic seminoma all -ve.
*CD30 +ve.
**-ve in [[seminoma]].
*CD117 -ve.<ref name=pmid17277761/>
**+ve in [[seminoma]].
Additional notes:
*AE1/AE3 +ve.
*AE1/AE3 +ve.
*CD30 +ve.
*OCT3/4 +ve.<ref name=pmid18045648>{{Cite journal  | last1 = Iczkowski | first1 = KA. | last2 = Butler | first2 = SL. | last3 = Shanks | first3 = JH. | last4 = Hossain | first4 = D. | last5 = Schall | first5 = A. | last6 = Meiers | first6 = I. | last7 = Zhou | first7 = M. | last8 = Torkko | first8 = KC. | last9 = Kim | first9 = SJ. | title = Trials of new germ cell immunohistochemical stains in 93 extragonadal and metastatic germ cell tumors. | journal = Hum Pathol | volume = 39 | issue = 2 | pages = 275-81 | month = Feb | year = 2008 | doi = 10.1016/j.humpath.2007.07.002 | PMID = 18045648 }}</ref>
*OCT3/4 +ve.<ref name=pmid18045648>{{Cite journal  | last1 = Iczkowski | first1 = KA. | last2 = Butler | first2 = SL. | last3 = Shanks | first3 = JH. | last4 = Hossain | first4 = D. | last5 = Schall | first5 = A. | last6 = Meiers | first6 = I. | last7 = Zhou | first7 = M. | last8 = Torkko | first8 = KC. | last9 = Kim | first9 = SJ. | title = Trials of new germ cell immunohistochemical stains in 93 extragonadal and metastatic germ cell tumors. | journal = Hum Pathol | volume = 39 | issue = 2 | pages = 275-81 | month = Feb | year = 2008 | doi = 10.1016/j.humpath.2007.07.002 | PMID = 18045648 }}</ref>
*D2-40 -ve.<ref name=pmid18045648/>
*D2-40 -ve.<ref name=pmid18045648/>
**Iczkowski ''et al.'' suggest it is useful for discriminating from [[seminoma]].  This is somewhat disputed by Lau ''et al.''<ref name=pmid17277761>{{Cite journal  | last1 = Lau | first1 = SK. | last2 = Weiss | first2 = LM. | last3 = Chu | first3 = PG. | title = D2-40 immunohistochemistry in the differential diagnosis of seminoma and embryonal carcinoma: a comparative immunohistochemical study with KIT (CD117) and CD30. | journal = Mod Pathol | volume = 20 | issue = 3 | pages = 320-5 | month = Mar | year = 2007 | doi = 10.1038/modpathol.3800749 | PMID = 17277761 }}</ref>
**Iczkowski ''et al.'' suggest it is useful for discriminating from [[seminoma]].  This is somewhat disputed by Lau ''et al.''<ref name=pmid17277761>{{Cite journal  | last1 = Lau | first1 = SK. | last2 = Weiss | first2 = LM. | last3 = Chu | first3 = PG. | title = D2-40 immunohistochemistry in the differential diagnosis of seminoma and embryonal carcinoma: a comparative immunohistochemical study with KIT (CD117) and CD30. | journal = Mod Pathol | volume = 20 | issue = 3 | pages = 320-5 | month = Mar | year = 2007 | doi = 10.1038/modpathol.3800749 | PMID = 17277761 }}</ref>
*CD117 -ve.<ref name=pmid17277761/>
*PLAP +ve.<ref name=pmid6209917>{{Cite journal  | last1 = Jacobsen | first1 = GK. | last2 = Nørgaard-Pedersen | first2 = B. | title = Placental alkaline phosphatase in testicular germ cell tumours and in carcinoma-in-situ of the testis. An immunohistochemical study. | journal = Acta Pathol Microbiol Immunol Scand A | volume = 92 | issue = 5 | pages = 323-9 | month = Sep | year = 1984 | doi =  | PMID = 6209917 }}</ref>
*PLAP +ve.<ref name=pmid6209917>{{Cite journal  | last1 = Jacobsen | first1 = GK. | last2 = Nørgaard-Pedersen | first2 = B. | title = Placental alkaline phosphatase in testicular germ cell tumours and in carcinoma-in-situ of the testis. An immunohistochemical study. | journal = Acta Pathol Microbiol Immunol Scand A | volume = 92 | issue = 5 | pages = 323-9 | month = Sep | year = 1984 | doi =  | PMID = 6209917 }}</ref>


Revision as of 03:05, 1 August 2014

Embryonal carcinoma
Diagnosis in short

Embryonal carcinoma. H&E stain.
LM vesicular nuclei, nuclear overlap, necrosis (common), mitoses, variable architecture (tubulopapillary, glandular, solid, embryoid bodies)
LM DDx seminoma, mixed germ cell tumour, yolk sac tumour, other carcinomas
IHC CD30 +ve, AE1/AE3 +ve
Site testis, ovary, mediastinum
Signs testicular mass, pelvic mass

Embryonal carcinoma is a type of germ cell tumour. It is commonly as a component of mixed germ cell tumours.

General

  • Affects young adults.
    • May be seen in women.

Gross

Microscopic

Features:[2]

  1. Nucleoli - key feature.
  2. Vesicular nuclei (clear, empty appearing nuclei) - key feature.
  3. Nuclei overlap.
  4. Necrosis - common.
    • Not commonly present in seminoma.
  5. Indistinct cell borders
  6. Mitoses - common.
  7. Variable architecture:
    • Tubulopapillary.
    • Glandular.
    • Solid.
    • Embryoid bodies - ball of cells in surrounded by empty space on three sides.

Notes:

  • Cytoplasmic staining variable (eosinophilic to basophilic).

DDx:

Images

  • Embryonal carcinoma - very high mag. - cropped (WC/Nephron)

  • Embryonal carcinoma - high mag. (WC/Nephron)

  • Embryonal carcinoma - high mag. (WC/Nephron)

  • Embryonal carcinoma - intermed. mag. (WC/Nephron)

  • Embryonal carcinoma - low mag. (WC/Nephron)

IHC

ISUP consensus paper by Ulbright et al.:[3]

  • OCT4 +ve.
    • Choriocarcinoma, yolk sac tumour and spermatocytic seminoma all -ve.
  • CD30 +ve.
  • CD117 -ve.[4]

Additional notes:

  • AE1/AE3 +ve.
  • OCT3/4 +ve.[5]
  • D2-40 -ve.[5]
    • Iczkowski et al. suggest it is useful for discriminating from seminoma. This is somewhat disputed by Lau et al.[4]
  • PLAP +ve.[6]

See also

References

  1. ↑ Yalçın, B.; Demir, HA.; Tanyel, FC.; Akçören, Z.; Varan, A.; Akyüz, C.; Kutluk, T.; Büyükpamukçu, M. (Oct 2012). "Mediastinal germ cell tumors in childhood.". Pediatr Hematol Oncol 29 (7): 633-42. doi:10.3109/08880018.2012.713084. PMID 22877235.
  2. ↑ Zhou, Ming; Magi-Galluzzi, Cristina (2006). Genitourinary Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 549. ISBN 978-0443066771.
  3. ↑ Ulbright TM, Tickoo SK, Berney DM, Srigley JR (August 2014). "Best practices recommendations in the application of immunohistochemistry in testicular tumors: report from the international society of urological pathology consensus conference". Am. J. Surg. Pathol. 38 (8): e50–9. doi:10.1097/PAS.0000000000000233. PMID 24832161.
  4. ↑ 4.0 4.1 Lau, SK.; Weiss, LM.; Chu, PG. (Mar 2007). "D2-40 immunohistochemistry in the differential diagnosis of seminoma and embryonal carcinoma: a comparative immunohistochemical study with KIT (CD117) and CD30.". Mod Pathol 20 (3): 320-5. doi:10.1038/modpathol.3800749. PMID 17277761.
  5. ↑ 5.0 5.1 Iczkowski, KA.; Butler, SL.; Shanks, JH.; Hossain, D.; Schall, A.; Meiers, I.; Zhou, M.; Torkko, KC. et al. (Feb 2008). "Trials of new germ cell immunohistochemical stains in 93 extragonadal and metastatic germ cell tumors.". Hum Pathol 39 (2): 275-81. doi:10.1016/j.humpath.2007.07.002. PMID 18045648.
  6. ↑ Jacobsen, GK.; Nørgaard-Pedersen, B. (Sep 1984). "Placental alkaline phosphatase in testicular germ cell tumours and in carcinoma-in-situ of the testis. An immunohistochemical study.". Acta Pathol Microbiol Immunol Scand A 92 (5): 323-9. PMID 6209917.
Retrieved from "https://librepathology.org/w/index.php?title=Embryonal_carcinoma&oldid=32940"