Difference between revisions of "Testis"

Jump to navigation Jump to search
(→‎IHC: wikify)
(split-out GCTs)
Line 257: Line 257:
*[http://commons.wikimedia.org/wiki/File:Spermatocytic_seminoma_high_mag.jpg Spermatocytic seminoma - high mag. (WC)].
*[http://commons.wikimedia.org/wiki/File:Spermatocytic_seminoma_high_mag.jpg Spermatocytic seminoma - high mag. (WC)].
*[http://commons.wikimedia.org/wiki/File:Spermatocytic_seminoma_intermed_mag.jpg Spermatocytic seminoma - intermed. mag. (WC)].
*[http://commons.wikimedia.org/wiki/File:Spermatocytic_seminoma_intermed_mag.jpg Spermatocytic seminoma - intermed. mag. (WC)].


==Yolk sac tumour==
==Yolk sac tumour==
===General===
{{Main|Yolk sac tumour}}
*Tumour also known as ''endodermal sinus tumour''.
 
===Epidemiology===
*Most common GCT in infants and young boys.
*Most common GCT in infants and young boys.


Line 271: Line 269:
*Architecure - variable.
*Architecure - variable.
**Most common ''microcystic pattern''.<ref>URL: [http://webpathology.com/image.asp?case=34&n=1 http://webpathology.com/image.asp?case=34&n=1]. Accessed on: March 8, 2010.</ref>
**Most common ''microcystic pattern''.<ref>URL: [http://webpathology.com/image.asp?case=34&n=1 http://webpathology.com/image.asp?case=34&n=1]. Accessed on: March 8, 2010.</ref>
Image:
*[http://www.webpathology.com/image.asp?case=34&n=5 Schiller-Duval body (webpathology.com)].
Variants:
*Hepatoid pattern.<ref>URL: [http://webpathology.com/image.asp?case=34&n=6 http://webpathology.com/image.asp?case=34&n=6]. Accessed on: March 8, 2010.</ref>
**Vaguely resembles liver.
***Hyaline globules (light red well-circumscribed globs).
***Bile canaculi.
*Solid pattern.<ref>URL: [http://webpathology.com/image.asp?case=34&n=8 http://webpathology.com/image.asp?case=34&n=8]. Accessed on: March 8, 2010.</ref>
**Vaguely resembles ''seminoma''.
Image:
*[http://webpathology.com/image.asp?case=34&n=6 Hepatoid Pattern].
===IHC===
*AFP +ve.
*Glypican 3 +ve.
**More sensitive than AFP.<ref name=pmid20438407>{{Cite journal  | last1 = Emerson | first1 = RE. | last2 = Ulbright | first2 = TM. | title = Intratubular germ cell neoplasia of the testis and its associated cancers: the use of novel biomarkers. | journal = Pathology | volume = 42 | issue = 4 | pages = 344-55 | month = Jun | year = 2010 | doi = 10.3109/00313021003767355 | PMID = 20438407 }}</ref>
*Alpha-1 AT +ve.
*Cytokeratin +ve. ???
===DDx===
*Embryonal carcinoma.


==Embryonal carcinoma==
==Embryonal carcinoma==
===General===
{{Main|Embryonal carcinoma}}
*Affects young adults.
These often look like a poorly differentiated carcinoma.
**May be seen in women.
 
===Microscopic===
Features:<ref name=Ref_GUP549>{{Ref GUP|549}}</ref>
#Nucleoli - '''key feature'''.
#Vesicular nuclei (clear, empty appearing nuclei) - '''key feature'''.
#Nuclei overlap.
#[[Necrosis]] - common.
#*Not commonly present in seminoma.
#Indistinct cell borders
#Mitoses - common.
#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).
 
Images:
*Set 1:
**[http://commons.wikimedia.org/wiki/File:Embryonal_carcinoma_-_very_high_mag_-_cropped.jpg Embryonal carcinoma - very high mag. - cropped (WC)].
**[http://commons.wikimedia.org/wiki/File:Embryonal_carcinoma_-_high_mag.jpg Embryonal carcinoma - high mag. (WC)].
*Set 2:
**[http://commons.wikimedia.org/wiki/File:Embryonal_carcinoma_high_mag.jpg Embryonal carcinoma - high mag. (WC)].
**[http://commons.wikimedia.org/wiki/File:Embryonal_carcinoma_intermed_mag.jpg Embryonal carcinoma - intermed. mag. (WC)].
**[http://commons.wikimedia.org/wiki/File:Embryonal_carcinoma_low_mag.jpg Embryonal carcinoma - low mag. (WC)].
 
===DDx===
*Yolk sac tumour.
 
===IHC===
*AE1/AE3 +ve.
*CD30 +ve.


==Choriocarcinoma==
==Choriocarcinoma==
===Clinical===
{{Main|Choriocarcinoma}}
*Aggressive clinical course.
There are aggressive tumours.
 
===Microscopy===
*Syncytiotrophoblasts:
**Large + many irreg. or lobular hyperchromatic nuclei.
**Eosinophilic vacuolated cytoplasm (contains hCG).
*'''C'''ytotrophoblasts:
**'''C'''lear cytoplasm.
**Polygonal shaped cells in cords/masses.
**Distinct cell borders.
**Single uniform nucleus.
*+/-Hemorrhage.
*+/-Necrosis.
 
Image(s):
*[http://www.webpathology.com/image.asp?case=36&n=1 Choriocarcinoma (webpathology.com)]
 
Notes:
*See: ''[[Chorionic villi]]''.
 
===IHC===
*beta-hCG +ve.


==Teratoma==
==Teratoma==
===General===
{{Main|Teratoma}}
*Consists of all three [[germ layers]]:<ref>{{cite book |author=Moore, Keith L.; Persaud, T.V.N.|title=The Developing Human: Clinically Oriented Embryology |publisher=Saunders |location= |year=2002 |pages= 83 |edition=7th |isbn=978-0721694122 |oclc= |doi= |accessdate=}}</ref>
In males these tumours are always malignant.
*#Endoderm:
*#*Skin, CNS.
*#Mesoderm:
*#*Muscle, bone, connective tissue, blood.
*#Ectoderm:
*#*Internal organs.
 
===Classification===
*Divided into:
**Mature.
**Immature.
 
===Immature===
*Immature if neural tissue is present:<ref>RS. 2 May 2010.</ref>
**Vaguely resembles pseudostratified respiratory epithelium.
*Islands of small hyperchromatic cells - "blastema".
*+/-Cartilage.
*+/-Adipocytes.
*+/-Colonic type mucosa.
*+/-Stratified squamous epithelium (skin).
 
Images:
*[http://commons.wikimedia.org/wiki/File:Immature_teratoma_high_mag.jpg Primitive neuroepithelium - high mag. (WC)].
*[http://commons.wikimedia.org/wiki/File:Primitive_neuroepithelium_intermed_mag.jpg Primitive neuroepithelium - intermed mag. (WC)]
*[http://commons.wikimedia.org/wiki/File:Teratoma_intermed_mag.jpg Teratoma - mature components (WC)].
 
Other images:
*[http://www.webpathology.com/image.asp?n=5&Case=35 Immature teratoma - myxomatous stroma (webpathology.com)].
*[http://www.webpathology.com/image.asp?n=6&Case=35 Immature teratoma - blastema (webpathology.com)].
*[http://www.webpathology.com/image.asp?n=7&Case=35 Immature teratoma - primitive neuroepithelium (webpathology.com)].
*[http://www.pathconsultddx.com/pathCon/largeImage?pii=S1559-8675%2806%2970278-9&figureId=fig2 Immature teratoma - primitive neuroepithelium (pathconsultddx.com)].
*[http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/N0C001-PQ01-M.htm Immature teratoma - primitive neuroepithelium (ouhsc.edu)].
 
===Grading===
Based on quantity of immature neuroepithelium:<ref name=pmid17080330>{{cite journal |author=Harms D, Zahn S, Göbel U, Schneider DT |title=Pathology and molecular biology of teratomas in childhood and adolescence |journal=Klin Padiatr |volume=218 |issue=6 |pages=296–302 |year=2006 |pmid=17080330 |doi=10.1055/s-2006-942271 |url=}}</ref><ref name=pmid15761467>{{cite journal |author=Ulbright TM |title=Germ cell tumors of the gonads: a selective review emphasizing problems in differential diagnosis, newly appreciated, and controversial issues |journal=Mod. Pathol. |volume=18 Suppl 2 |issue= |pages=S61–79 |year=2005 |month=February |pmid=15761467 |doi=10.1038/modpathol.3800310 |url=http://www.nature.com/modpathol/journal/v18/n2s/full/3800310a.html}}</ref><ref name=pmid7814189>{{cite journal |author=O'Connor DM, Norris HJ |title=The influence of grade on the outcome of stage I ovarian immature (malignant) teratomas and the reproducibility of grading |journal=Int. J. Gynecol. Pathol. |volume=13 |issue=4 |pages=283–9 |year=1994 |month=October |pmid=7814189 |doi= |url=}}</ref>
*G0 - mature teratoma; no immature neuroepithelium.
*G1 - less than one lower power field ([[LPF]]) of immature neuroepithelium; LPF defined field at 4X magnification.
*G2 - 1-3 LPFs.
*G3 - more than 3 LPFs.
 
Note:
*LPF not adequately defined - see [[LPFitis]]. Same BS as HPF.
 
===IHC (immature)===
Features:
*Primitive neuroepithelium:<ref name=pmid11598856>{{cite journal |author=Craver RD, Lipscomb JT, Suskind D, Velez MC |title=Malignant teratoma of the thyroid with primitive neuroepithelial and mesenchymal sarcomatous components |journal=Ann Diagn Pathol |volume=5 |issue=5 |pages=285–92 |year=2001 |month=October |pmid=11598856 |doi=10.1053/adpa.2001.27918 |url=}}</ref>
**Neuron-specific enolase (NSE) +ve.
**Neuron-specific B tubulin +ve.
**Synaptophysin +ve.


==Leydig cell tumour==
==Leydig cell tumour==
Retrieved from "https://librepathology.org/wiki/Testis"