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Difference between revisions of "Seminoma"
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| Micro = fried egg-like cells (clear or eosinophilic cytoplasm, central nucleus), lymphocytic infiltrate (common), +/-[[syncytiotrophoblast]]s (rare), +/-granulomas (uncommon) | | Micro = fried egg-like cells (clear or eosinophilic cytoplasm, central nucleus), lymphocytic infiltrate (common), +/-[[syncytiotrophoblast]]s (rare), +/-granulomas (uncommon) | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[embryonal carcinoma]], [[GCNIS]], [[mixed germ cell tumour]], [[granulomatous orchitis]], [[testicular scar]], [[atrophic testis]] | | LMDDx = [[embryonal carcinoma]], [[GCNIS]], [[mixed germ cell tumour]], [[granulomatous orchitis]], [[testicular scar]], [[atrophic testis]], [[diffuse large B-cell lymphoma]] | ||
| Stains = | | Stains = | ||
| IHC = OCT4 +ve, [[CD117]] +ve, CD30 -ve | | IHC = OCT4 +ve, [[CD117]] +ve, CD30 -ve | ||
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| Symptoms = | | Symptoms = | ||
| Prevalence = | | Prevalence = | ||
| Bloodwork = LDH elevated, beta-hCG elevated | | Bloodwork = LDH elevated, beta-hCG normal or slightly elevated | ||
| Rads = | | Rads = | ||
| Endoscopy = | | Endoscopy = | ||
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'''Seminoma''' is a common [[testis|testicular]] [[germ cell tumour]]. | '''Seminoma''' is a common [[testis|testicular]] [[germ cell tumour]]. | ||
It should ''not'' be confused with | It should ''not'' be confused with ''[[spermatocytic tumour]]'' (previously known as ''spermatocytic seminoma''). | ||
==General== | ==General== | ||
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*Elevated serum LDH. | *Elevated serum LDH. | ||
*Normal serum alpha fetoprotein. | *Normal serum alpha fetoprotein. | ||
*Usually normal beta-hCG. | *Usually normal beta-hCG ''or'' slightly elevated.<ref name=pmid9311009>{{cite journal |authors=Hori K, Uematsu K, Yasoshima H, Yamada A, Sakurai K, Ohya M |title=Testicular seminoma with human chorionic gonadotropin production |journal=Pathol Int |volume=47 |issue=9 |pages=592–9 |date=September 1997 |pmid=9311009 |doi=10.1111/j.1440-1827.1997.tb04547.x |url=}}</ref> | ||
Note: | Note: | ||
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*[[Testicular scar]] - seminomas may regress spontaneously. | *[[Testicular scar]] - seminomas may regress spontaneously. | ||
*[[Testicular atrophy]] - esp. for intertubular predominant seminoma.<ref name=pmid15316315>{{Cite journal | last1 = Henley | first1 = JD. | last2 = Young | first2 = RH. | last3 = Wade | first3 = CL. | last4 = Ulbright | first4 = TM. | title = Seminomas with exclusive intertubular growth: a report of 12 clinically and grossly inconspicuous tumors. | journal = Am J Surg Pathol | volume = 28 | issue = 9 | pages = 1163-8 | month = Sep | year = 2004 | doi = | PMID = 15316315 }}</ref> | *[[Testicular atrophy]] - esp. for intertubular predominant seminoma.<ref name=pmid15316315>{{Cite journal | last1 = Henley | first1 = JD. | last2 = Young | first2 = RH. | last3 = Wade | first3 = CL. | last4 = Ulbright | first4 = TM. | title = Seminomas with exclusive intertubular growth: a report of 12 clinically and grossly inconspicuous tumors. | journal = Am J Surg Pathol | volume = 28 | issue = 9 | pages = 1163-8 | month = Sep | year = 2004 | doi = | PMID = 15316315 }}</ref> | ||
*[[Diffuse large B-cell lymphoma]] - may be OCT4 +ve and rarely SALL4 +ve.<ref name=pmid27035612>{{cite journal |authors=Williams AS, Shawwa A, Merrimen J, Dakin Haché K |title=Expression of OCT4 and SALL4 in Diffuse Large B-cell Lymphoma: An Analysis of 145 Consecutive Cases and Testicular Lymphomas |journal=Am J Surg Pathol |volume=40 |issue=7 |pages=950–7 |date=July 2016 |pmid=27035612 |doi=10.1097/PAS.0000000000000648 |url=}}</ref> | |||
===Images=== | ===Images=== | ||
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A general panel:<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> | A general panel:<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. | *OCT4 +ve. | ||
**Choriocarcinoma, yolk sac tumour and spermatocytic | **Choriocarcinoma, yolk sac tumour and [[spermatocytic tumour]] all -ve. | ||
*CD117 +ve. | *CD117 +ve. | ||
**-ve in embryonal carcinoma. | **-ve in embryonal carcinoma. | ||
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==Sign out== | ==Sign out== | ||
<pre> | |||
Right Testicle, Radical Orchitectomy: | |||
- SEMINOMA (pure). | |||
-- Margins clear. | |||
-- Germ cell neoplasia in situ (intratubular germ cell neoplasia) present. | |||
-- Please see synoptic report. | |||
- Background testis consists of Sertoli cells only, NEGATIVE for spermatogenesis. | |||
</pre> | |||
<pre> | <pre> | ||
Testis, Left, Radical Orchiectomy: | Testis, Left, Radical Orchiectomy: | ||
- SEMINOMA (pure). | |||
-- Margins clear. | |||
-- Please see synoptic report. | |||
</pre> | </pre> | ||
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<pre> | <pre> | ||
RETROPERITONEAL SOFT TISSUE, RIGHT, CORE BIOPSY: | RETROPERITONEAL SOFT TISSUE, RIGHT, CORE BIOPSY: | ||
- SEMINOMA. | - SEMINOMA. | ||
</pre> | </pre> | ||