Spermatocytic tumour: Difference between revisions

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-#redirect [[Testis#Spermatocytic_seminoma]]
+{{ Infobox diagnosis
+| Name       = {{PAGENAME}}
+| Image      = Spermatocytic_seminoma_high_mag.jpg
+| Width      =
+| Caption    = Spermatocytic tumour
+| Synonyms   = spermatocytic seminoma (old term, not recommended by World Health Organization)
+| Micro      = three cell populations: (1) small cells (6-8 µm) - with a large NC ratio, (2) medium cells (15-18 µm) with prominent nucleoli and spireme chromatin, (3) Large cells (50-100 µm) with spireme chromatin; mucoid lakes, intratubular spread
+| Subtypes   =
+| LMDDx      = [[DLBCL]], [[seminoma]]
+| Stains     =
+| IHC        = SALL4 +ve, OCT3/4 -ve, CD117 +ve/-ve
+| EM         =
+| Molecular  =
+| IF         =
+| Gross      =
+| Grossing   =
+| Site       = [[testis]]
+| Assdx      =
+| Syndromes  =
+| Clinicalhx =
+| Signs      = mass lesion
+| Symptoms   =
+| Prevalence = rare
+| Bloodwork  =
+| Rads       =
+| Endoscopy  =
+| Prognosis  = benign, good
+| Other      =
+| ClinDDx    = other [[germ cell tumours]], [[lymphoma]]
+| Tx         = excision to exclude malignancy
+}}
+'''Spermatocytic tumour''' is a rare benign testicular tumour.
+It was previously known as '''spermatocytic seminoma'''. It should ''not'' be confused with [[seminoma]] which is an unrelated tumour.
+==General==
+*Rare tumour.
+*Only one case of metastases in 200 cases.<ref name=pmid7927308>{{cite journal |author=Eble JN |title=Spermatocytic seminoma |journal=Hum. Pathol. |volume=25 |issue=10 |pages=1035–42 |year=1994 |month=October |pmid=7927308 |doi= |url=}}</ref>
+*Orchiectomy is curative.
+*Not reported/found in females.<ref name=pmid7927308/>
+*Typically older - mean age 50s.<ref name=pmid7927308/>
+===Epidemiology===
+*Does ''not'' arise from ''[[germ cell neoplasia in situ]]'' (previously known as ''intratubular germ cell neoplasia'')<ref name=pmid3583416>{{cite journal |author=Müller J, Skakkebaek NE, Parkinson MC |title=The spermatocytic seminoma: views on pathogenesis |journal=Int. J. Androl. |volume=10 |issue=1 |pages=147–56 |year=1987 |month=February |pmid=3583416 |doi= 10.1111/j.1365-2605.1987.tb00176.x|url=}}</ref> - '''not''' considered a subtype of [[seminoma]].
+==Microscopic==
+Features:<ref>{{cite book |author=Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. |title=Robbins and Cotran pathologic basis of disease |publisher=Elsevier Saunders |location=St. Louis, Mo |year=2005 |pages= |edition=7th |isbn=0-7216-0187-1 |oclc= |doi= |accessdate=}}</ref>
+*Population of three cells.
+*#Small cells (6-8 µm) - with a large NC [[ratio]].
+*#*Look like secondary spermatocytes.
+*#*May be confused with (mature) lymphocytes.
+*#Medium cells (15-18 µm) with prominent nucleoli.
+*#*Filamentous chromatin (AKA ''spireme chromatin'').<ref name=pmid7927308>{{cite journal |author=Eble JN |title=Spermatocytic seminoma |journal=Hum. Pathol. |volume=25 |issue=10 |pages=1035–42 |year=1994 |month=October |pmid=7927308 |doi= |url=}}</ref>
+*#Large cells (50-100 µm).
+*#*Filamentous chromatin.
+*Mucoid lakes.
+*Intratubular spread.
+Notes:
+*''Spireme'' = the tangle of filaments in prophase portion of mitosis.<ref>URL: [http://www.thefreedictionary.com/spireme http://www.thefreedictionary.com/spireme]. Accessed on: 4 June 2010.</ref>
+*May have eosinophilic cytoplasm (dependent on lab).
+**Usually larger than [[Leydig cell tumour]].
+DDx:
+*[[DLBCL]].
+*[[Seminoma]].
+===Images===
+<gallery>
+Image:Spermatocytic_seminoma_high_mag.jpg | Spermatocytic tumour - high mag. (WC)
+Image:Spermatocytic_seminoma_intermed_mag.jpg | Spermatocytic tumour - intermed. mag. (WC)
+Image:testicular spermatocytic tumour high mag.jpg | Spermatocytic tumour - high mag. (WC)
+</gallery>
+==IHC==
+Features:<ref name=pmid10223302>{{Cite journal  | last1 = Kraggerud | first1 = SM. | last2 = Berner | first2 = A. | last3 = Bryne | first3 = M. | last4 = Pettersen | first4 = EO. | last5 = Fossa | first5 = SD. | title = Spermatocytic seminoma as compared to classical seminoma: an immunohistochemical and DNA flow cytometric study. | journal = APMIS | volume = 107 | issue = 3 | pages = 297-302 | month = Mar | year = 1999 | doi =  | PMID = 10223302 }}</ref>
+*[[PLAP]] -ve (0 positive/17).
+*CD117 -ve (7 positive/17).
+*CAM5.2 -ve (1 positive/17).
+Others:<ref>{{Ref WHOGU2022|289}}</ref>
+*SALL4 +ve.
+*OCT3/4 -ve.
+*AFP -ve.
+*CD30 -ve.
+*Beta-hCG -ve.
+==Sign out==
+<pre>
+Left Testis, Radical Orchiectomy:
+	- Spermatocytic tumour, see comment.
+	- NEGATIVE for germ cell neoplasia in situ.
+	- Background testis with spermatogenesis and atrophy.
+Comment:
+Spermatocytic tumours are rare. They are not associated with germ cell neoplasia in situ (GCNIS) and typically not seen together with other germ cell types.
+The tumour stains as follows:
+POSITIVE: CD117 (moderate, patchy), SALL4 (moderate, diffuse), BCL2 (scattered cells, moderate membranous).
+NEGATIVE: AE1/AE3, AFP, CD31, CD34, calretinin, hCG, CD3, CD10, CD20, CD30, CD45, GATA3, PLAP, PSA, OCT3/4, CAM5.2, D2-40.
+This tumour (spermatoctyic tumour) was previously known as "spermatocytic seminoma".  The term "spermatocytic seminoma" is no longer recommended by the World Health Organization, presumably as the name may: (1) create confusion with "seminoma" and (2) falsely raise the possibility of a mixed tumour (that develops in the context of GCNIS).
+</pre>
+===Micro===
+This tumour has three cell types with spireme chromatin in the larger and intermediate cell type. Infiltrating lymphocytes are absent.
+The background testis has some spermatogenesis and atrophic change. Germ cell neoplasia in situ (GCNIS) is ABSENT.  The seminiferous tubules adjacent to the tumour, where visualized, are atrophic.
+==See also==
+*[[Testis]].
+*[[Genitourinary pathology]].
+==References==
+{{Reflist|1}}
 [[Category:Diagnosis]]
+[[Category:Genitourinary pathology]]

Spermatocytic tumour: Difference between revisions

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