Spermatocytic tumour

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Spermatocytic seminoma is a rare benign testicular tumour. It should not be confused with seminoma which is an unrelated tumour.

Spermatocytic tumour
Diagnosis in short

Spermatocytic seminoma

LM three cell sizes: (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
LM DDx DLBCL, seminoma
Site testis

Signs mass lesion
Prognosis benign, good
Clin. DDx other germ cell tumours, lymphoma

General

  • Rare tumour.
  • Only one case of metastases in 200 cases.[1]
  • Orchiectomy is curative.
  • Not reported/found in females.[1]
  • Typically older - mean age 50s.[1]

Epidemiology

Microscopic

Features:[3]

  • Population of three cells.
    1. Small cells (6-8 µm) - with a large NC ratio.
      • Look like secondary spermatocytes.
      • May be confused with (mature) lymphocytes.
    2. Medium cells (15-18 µm) with prominent nucleoli.
      • Filamentous chromatin (AKA spireme chromatin).[1]
    3. Large cells (50-100 µm).
      • Filamentous chromatin.
  • Mucoid lakes.
  • Intratubular spread.

Notes:

  • Spireme = the tangle of filaments in prophase portion of mitosis.[4]
  • May have eosinophilic cytoplasm (dependent on lab).

DDx:

Images

IHC

Features:[5]

  • PLAP -ve (0 positive/17).
  • CD117 -ve (7 positive/17).
  • CAM5.2 -ve (1 positive/17).

See also

References

  1. 1.0 1.1 1.2 1.3 Eble JN (October 1994). "Spermatocytic seminoma". Hum. Pathol. 25 (10): 1035–42. PMID 7927308.
  2. Müller J, Skakkebaek NE, Parkinson MC (February 1987). "The spermatocytic seminoma: views on pathogenesis". Int. J. Androl. 10 (1): 147–56. doi:10.1111/j.1365-2605.1987.tb00176.x. PMID 3583416.
  3. Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. ISBN 0-7216-0187-1.
  4. URL: http://www.thefreedictionary.com/spireme. Accessed on: 4 June 2010.
  5. Kraggerud, SM.; Berner, A.; Bryne, M.; Pettersen, EO.; Fossa, SD. (Mar 1999). "Spermatocytic seminoma as compared to classical seminoma: an immunohistochemical and DNA flow cytometric study.". APMIS 107 (3): 297-302. PMID 10223302.