Sertoli cell nodule

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Sertoli cell nodule, abbreviated SCN, is a benign lesion of the testis that is usually incidental.

Sertoli cell nodule
Diagnosis in short

Sertoli cell nodule. H&E stain.

Synonyms Pick's adenoma, testicular tubular adenoma, tubular adenoma of the testis

LM unencapsulated nodules composed of well-formed tubules, +/eosinophilic (hyaline) blob in lumen (centre), cells - vaguely resemble immature Sertoli cells (bland hyperchromatic oval/round nuclei) but are stratified (somewhat like a tubular adenoma of the gastrointestinal tract)
LM DDx Sertoli cell tumour, sex cord tumour with annular tubules, gonadoblastoma
IHC alpha-inhibin +ve, PLAP -ve
Site testis

Clinical history +/-undescended testis
Prevalence uncommon in general

It is also known as Pick's adenoma, testicular tubular adenoma and tubular adenoma of the testis.

General

  • Benign proliferation of Sertoli cells - associated with cryptorchidism (undescended testis).
  • Not composed of a clonal cell population, i.e. not neoplastic; thus, technically, should not be called an adenoma.[1]

Gross

  • Usually an incidental finding, rarely presents as a testicular mass.[2]

Microscopic

Features:[1][3]

  • Unencapsulated nodules composed of well-formed tubules.
    • May contain eosinophilic (hyaline) blob in lumen (centre).
  • Cells - vaguely resemble immature Sertoli cells:

DDx:[2]

Images

IHC

Features:[2]

  • Alpha-inhibin +ve (5/5 cases).
  • OCT3/4 -ve (5/5 cases).

Other:

  • PLAP -ve.

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TESTICLE, LEFT, ORCHIECTOMY:
- ATROPHIC TESTICLE WITH SERTOLI CELL NODULES.
- NEGATIVE FOR INTRATUBULAR GERM CELL NEOPLASIA.
- NEGATIVE FOR MALIGNANCY.

COMMENT:
The above findings are supported by immunostains. The tubules stain with alpha-inhibin and
are negative for PLAP. 

See also

References

  1. 1.0 1.1 Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 227. ISBN 978-0470519035.
  2. 2.0 2.1 2.2 Vallangeon, BD.; Eble, JN.; Ulbright, TM. (Dec 2010). "Macroscopic sertoli cell nodule: a study of 6 cases that presented as testicular masses.". Am J Surg Pathol 34 (12): 1874-80. doi:10.1097/PAS.0b013e3181fcab70. PMID 21107095.
  3. Ricco R, Bufo P (October 1980). "[Histologic study of 3 cases of so-called tubular adenoma of the testis]" (in Italian). Boll. Soc. Ital. Biol. Sper. 56 (20): 2110–5. PMID 6109541.