Difference between revisions of "Papillary cystadenoma of the epididymis"
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'''Papillary cystadenoma of the epididymis''' is a rare benign epithelial tumour of the epididymis.<ref name=pmid23708309>{{Cite journal | last1 = Toutziaris | first1 = C. | last2 = Kampantais | first2 = S. | last3 = Perdikis | first3 = I. | last4 = Gourvas | first4 = V. | last5 = Laskaridis | first5 = L. | last6 = Gkagkalidis | first6 = K. | last7 = Lakis | first7 = S. | last8 = Ioannidis | first8 = S. | title = Papillary cystadenoma of epididymis: Is there a need for further investigation in unilateral cases? | journal = Int J Surg Case Rep | volume = 4 | issue = 7 | pages = 616-8 | month = | year = 2013 | doi = 10.1016/j.ijscr.2013.03.038 | PMID = 23708309 }}</ref> | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | |||
| Image = Papillary_cystadenoma_of_epididymis_--_high_mag.jpg | |||
| Width = | |||
| Caption = Papillary cystadenoma of epididymis. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = cystic spaces with papillae lined by clear cells with moderate cytoplasm | |||
| Subtypes = | |||
| LMDDx = serous borderline tumour of the paratestis, [[adenomatoid tumour]], metastatic [[clear cell carcinoma]] (esp. [[clear cell renal cell carcinoma]]) | |||
| Stains = | |||
| IHC = AE1/AE3 +ve, EMA +ve, CD10 -ve | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = solid and/or cystic mass, well-circumscribed | |||
| Grossing = | |||
| Site = [[epididymis]] | |||
| Assdx = | |||
| Syndromes = [[von Hippel-Lindau disease]] | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = +/-scrotal swelling | |||
| Prevalence = rare | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = testicular masses - esp. [[germ cell tumours]], [[paratesticular lesion]]s | |||
| Tx = excision | |||
}} | |||
'''Papillary cystadenoma of the epididymis''' is a rare benign epithelial tumour of the [[epididymis]].<ref name=pmid23708309>{{Cite journal | last1 = Toutziaris | first1 = C. | last2 = Kampantais | first2 = S. | last3 = Perdikis | first3 = I. | last4 = Gourvas | first4 = V. | last5 = Laskaridis | first5 = L. | last6 = Gkagkalidis | first6 = K. | last7 = Lakis | first7 = S. | last8 = Ioannidis | first8 = S. | title = Papillary cystadenoma of epididymis: Is there a need for further investigation in unilateral cases? | journal = Int J Surg Case Rep | volume = 4 | issue = 7 | pages = 616-8 | month = | year = 2013 | doi = 10.1016/j.ijscr.2013.03.038 | PMID = 23708309 }}</ref> | |||
''Papillary cystadenoma'' redirects here. | |||
==General== | ==General== | ||
*May be associated with [[von Hippel-Lindau disease]].<ref name=pmid23708309/> | *May be associated with [[von Hippel-Lindau disease]].<ref name=pmid23708309/> | ||
**One third of reported cases associated with vHL.<ref name=pmid20367315/> | |||
**Classically bilateral involvement.<ref name=pmid20367315/> | |||
*Large age range (16-76 years old).<ref name=pmid20367315/> | |||
*Typically young adults (median age 30 years old).<ref name=pmid20367315/> | |||
Clinical:<ref name=pmid20367315/> | |||
*Slow growing scrotal mass or incidental finding. | |||
==Gross== | |||
*Well-circumscribed mass. | |||
*Solid and/or cystic. | |||
==Microscopic== | ==Microscopic== | ||
Features: | Features:<ref name=pmid20367315/> | ||
*Clear cells. | *Clear cells with moderate cytoplasm and bland nuclear features (no [[nuclear atypia]]). | ||
**Often arranged in nests. | |||
*Cystic spaces (often microscopic and macroscopic). | |||
*Papillary structures - may be rare. | |||
DDx: | DDx: | ||
| Line 14: | Line 61: | ||
===Images=== | ===Images=== | ||
====Case==== | |||
<gallery> | |||
Image: Papillary cystadenoma of epididymis -- very low mag.jpg | PCE - very low mag. | |||
Image: Papillary cystadenoma of epididymis -- low mag.jpg | PCE - low mag. | |||
Image: Papillary cystadenoma of epididymis - alt -- low mag.jpg | PCE - low mag. | |||
Image: Papillary cystadenoma of epididymis -- intermed mag.jpg | PCE - intermed. mag. | |||
Image: Papillary cystadenoma of epididymis -- high mag.jpg | PCE - high mag. | |||
Image: Papillary cystadenoma of epididymis -- very low high.jpg | PCE - very high mag. | |||
</gallery> | |||
====www==== | |||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3679418/figure/fig0020/ PC (nih.gov)].<ref name=pmid23708309/> | *[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3679418/figure/fig0020/ PC (nih.gov)].<ref name=pmid23708309/> | ||
*[http://www.archivesofpathology.org/action/showFullPopup?id=i1543-2165-134-4-630-f01&doi=10.1043%2F1543-2165-134.4.630 PC (archivesofpathology.org)].<ref name=pmid20367315>{{Cite journal | last1 = Odrzywolski | first1 = KJ. | last2 = Mukhopadhyay | first2 = S. | title = Papillary cystadenoma of the epididymis. | journal = Arch Pathol Lab Med | volume = 134 | issue = 4 | pages = 630-3 | month = Apr | year = 2010 | doi = 10.1043/1543-2165-134.4.630 | PMID = 20367315 }}</ref> | |||
==IHC== | |||
Features:<ref name=pmid20367315>{{Cite journal | last1 = Odrzywolski | first1 = KJ. | last2 = Mukhopadhyay | first2 = S. | title = Papillary cystadenoma of the epididymis. | journal = Arch Pathol Lab Med | volume = 134 | issue = 4 | pages = 630-3 | month = Apr | year = 2010 | doi = 10.1043/1543-2165-134.4.630 | PMID = 20367315 }}</ref> | |||
*AE1/AE3 (7 of 7 cases). | |||
*EMA +ve (9 of 9 cases). | |||
*CK7 +v3 (3 of 3 cases). | |||
*PAX8 +ve (6 of 7 cases<ref name=pmid24441657>{{Cite journal | last1 = Cox | first1 = R. | last2 = Vang | first2 = R. | last3 = Epstein | first3 = JI. | title = Papillary cystadenoma of the epididymis and broad ligament: morphologic and immunohistochemical overlap with clear cell papillary renal cell carcinoma. | journal = Am J Surg Pathol | volume = 38 | issue = 5 | pages = 713-8 | month = May | year = 2014 | doi = 10.1097/PAS.0000000000000152 | PMID = 24441657 }}</ref>) | |||
Others:<ref name=pmid20367315/> | |||
*Vimentin +ve/-ve (3 of 6 cases +ve). | |||
*CD10 -ve (0 +ve of 5 cases). | |||
*CK20 -ve (0 +ve of 4 cases). | |||
*S100 -ve (1 +ve of 4 cases). | |||
*RCC -ve (0 +ve of 7 cases<ref name=pmid24441657/>). | |||
*AMACR -ve (2 weakly +ve of 7 cases<ref name=pmid24441657/>). | |||
Note: | |||
*''Papillary cystadenoma of the epithymis'' has an immunoprofile that is nearly identical to [[clear cell papillary renal cell carcinoma]].<ref name=pmid24441657/> | |||
==Sign out== | |||
<pre> | |||
Right Epididymis, Mass, Excision: | |||
- Papillary cystadenoma of the epididymis, see comment | |||
Comment: | |||
The tumour stains as follows: | |||
POSITIVE: AE1/AE3, vimentin | |||
NEGATIVE: CD10, calretinin, CD68, S100, OCT3/4 | |||
Papillary cystadenoma of the epididymis is a benign uncommon | |||
tumour. Approximately 60 cases are reported in the literature. | |||
It is associated with von Hippel-Lindau disease in approximately | |||
1/3 of cases. | |||
</pre> | |||
==See also== | ==See also== | ||
Latest revision as of 18:16, 31 May 2016
| Papillary cystadenoma of the epididymis | |
|---|---|
| Diagnosis in short | |
 Papillary cystadenoma of epididymis. H&E stain. | |
|
| |
| LM | cystic spaces with papillae lined by clear cells with moderate cytoplasm |
| LM DDx | serous borderline tumour of the paratestis, adenomatoid tumour, metastatic clear cell carcinoma (esp. clear cell renal cell carcinoma) |
| IHC | AE1/AE3 +ve, EMA +ve, CD10 -ve |
| Gross | solid and/or cystic mass, well-circumscribed |
| Site | epididymis |
|
| |
| Syndromes | von Hippel-Lindau disease |
|
| |
| Symptoms | +/-scrotal swelling |
| Prevalence | rare |
| Prognosis | benign |
| Clin. DDx | testicular masses - esp. germ cell tumours, paratesticular lesions |
| Treatment | excision |
Papillary cystadenoma of the epididymis is a rare benign epithelial tumour of the epididymis.[1]
Papillary cystadenoma redirects here.
General
- May be associated with von Hippel-Lindau disease.[1]
- Large age range (16-76 years old).[2]
- Typically young adults (median age 30 years old).[2]
Clinical:[2]
- Slow growing scrotal mass or incidental finding.
Gross
- Well-circumscribed mass.
- Solid and/or cystic.
Microscopic
Features:[2]
- Clear cells with moderate cytoplasm and bland nuclear features (no nuclear atypia).
- Often arranged in nests.
- Cystic spaces (often microscopic and macroscopic).
- Papillary structures - may be rare.
DDx:
- Adenomatoid tumour.
- Serous borderline tumour of the paratestis.
- Metastatic clear cell tumours - esp. clear cell renal cell carcinoma.
Images
Case
PCE - very low mag.
PCE - low mag.
PCE - low mag.
PCE - intermed. mag.
PCE - high mag.
PCE - very high mag.
www
IHC
Features:[2]
- AE1/AE3 (7 of 7 cases).
- EMA +ve (9 of 9 cases).
- CK7 +v3 (3 of 3 cases).
- PAX8 +ve (6 of 7 cases[3])
Others:[2]
- Vimentin +ve/-ve (3 of 6 cases +ve).
- CD10 -ve (0 +ve of 5 cases).
- CK20 -ve (0 +ve of 4 cases).
- S100 -ve (1 +ve of 4 cases).
- RCC -ve (0 +ve of 7 cases[3]).
- AMACR -ve (2 weakly +ve of 7 cases[3]).
Note:
- Papillary cystadenoma of the epithymis has an immunoprofile that is nearly identical to clear cell papillary renal cell carcinoma.[3]
Sign out
Right Epididymis, Mass, Excision: - Papillary cystadenoma of the epididymis, see comment Comment: The tumour stains as follows: POSITIVE: AE1/AE3, vimentin NEGATIVE: CD10, calretinin, CD68, S100, OCT3/4 Papillary cystadenoma of the epididymis is a benign uncommon tumour. Approximately 60 cases are reported in the literature. It is associated with von Hippel-Lindau disease in approximately 1/3 of cases.
See also
References
- ↑ 1.0 1.1 1.2 Toutziaris, C.; Kampantais, S.; Perdikis, I.; Gourvas, V.; Laskaridis, L.; Gkagkalidis, K.; Lakis, S.; Ioannidis, S. (2013). "Papillary cystadenoma of epididymis: Is there a need for further investigation in unilateral cases?". Int J Surg Case Rep 4 (7): 616-8. doi:10.1016/j.ijscr.2013.03.038. PMID 23708309.
- ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 2.8 Odrzywolski, KJ.; Mukhopadhyay, S. (Apr 2010). "Papillary cystadenoma of the epididymis.". Arch Pathol Lab Med 134 (4): 630-3. doi:10.1043/1543-2165-134.4.630. PMID 20367315.
- ↑ 3.0 3.1 3.2 3.3 Cox, R.; Vang, R.; Epstein, JI. (May 2014). "Papillary cystadenoma of the epididymis and broad ligament: morphologic and immunohistochemical overlap with clear cell papillary renal cell carcinoma.". Am J Surg Pathol 38 (5): 713-8. doi:10.1097/PAS.0000000000000152. PMID 24441657.