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Difference between revisions of "Mixed germ cell tumour"
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| IF = | | IF = | ||
| Gross = heterogeneous appearance, typically solid and cystic | | Gross = heterogeneous appearance, typically solid and cystic | ||
| Grossing = [[orchiectomy]] | | Grossing = [[orchiectomy grossing]] | ||
| Staging = [[testicular cancer staging]] | |||
| Site = [[ovary]], [[testis]], [[mediastinum]], other | | Site = [[ovary]], [[testis]], [[mediastinum]], other | ||
| Assdx = | | Assdx = | ||
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| Symptoms = | | Symptoms = | ||
| Prevalence = most common germ cell tumour | | Prevalence = most common germ cell tumour | ||
| Bloodwork = +/-AFP elevated, +/-beta-hCG elevated, +/-LDH elevated | | Bloodwork = +/-[[AFP]] elevated, +/-beta-hCG elevated, +/-LDH elevated | ||
| Rads = | | Rads = | ||
| Endoscopy = | | Endoscopy = | ||
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*Heterogeneous appearance - distinctive regions that look different from one another. | *Heterogeneous appearance - distinctive regions that look different from one another. | ||
*Typically solid and cystic. | *Typically solid and cystic. | ||
===Images=== | |||
<gallery> | |||
Image:Mixed_Germ_Cell_Tumor_of_Testis_(3260625567).jpg | Mixed germ cell tumour. (WC/euthman) | |||
</gallery> | |||
==Microscopic== | ==Microscopic== | ||
Features: | Features: | ||
*Depends on components | *Depends on the components. | ||
*Classic appearances: | |||
**[[Seminoma]]: fried egg-like" cells with lymphocytes. | |||
**[[Yolk sac tumour]]: edematous appearing/paucicellular regions, Schiller-Duval bodies. | |||
**[[Embryonal carcinoma]]: moderate-to-marked [[nuclear atypia]] with overlapping nuclei and usu. necrosis. | |||
**[[Teratoma]]: cysts with GI like epithelium, cysts with squamous epithelium & keratin (skin), immature cartilage, others. | |||
**[[Choriocarcinoma]]: hemorrhagic, multinucleated cells (syncytiotrophoblasts) and cells with pale cytoplasm (cytotrophoblasts). | |||
Notes: | Notes: | ||
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==IHC== | ==IHC== | ||
*Immunostains are useful for differentiating components, e.g. [[yolk sac tumour]] versus [[embryonal carcinoma]]. | |||
Looking for elements | |||
*Beta-hCG +ve - if syncytiotrophoblasts are present. | *Beta-hCG +ve - if syncytiotrophoblasts are present. | ||
*AFP +ve - a yolk sac tumour component is present. | *[[AFP]] +ve (or Glypican 3 +ve) - a yolk sac tumour component is present. | ||
*GFAP +ve - if neuroepithelium is present. | *GFAP +ve - if neuroepithelium is present. | ||
A panel: | A panel: | ||
*CD30 +ve -- [[embryonal carcinoma]]. | *CD30 +ve -- [[embryonal carcinoma]]. | ||
* | *OCT4 +ve -- [[seminoma]]. | ||
*D2-40 +ve -- seminoma, useful for [[LVI]]. | *D2-40 +ve -- seminoma, useful for [[LVI]]. | ||
*Pankeratin +ve -- embryonal carcinoma. | *[[Pankeratin]] +ve -- embryonal carcinoma. | ||
*CEA-M. | *CEA-M. | ||
*EMA +ve -- metastatic carcinoma.<ref>{{Cite journal | last1 = Shek | first1 = TW. | last2 = Yuen | first2 = ST. | last3 = Luk | first3 = IS. | last4 = Wong | first4 = MP. | title = Germ cell tumour as a diagnostic pitfall of metastatic carcinoma. | journal = J Clin Pathol | volume = 49 | issue = 3 | pages = 223-5 | month = Mar | year = 1996 | doi = | PMID = 8675733 }}</ref> | *[[EMA]] +ve -- metastatic carcinoma.<ref>{{Cite journal | last1 = Shek | first1 = TW. | last2 = Yuen | first2 = ST. | last3 = Luk | first3 = IS. | last4 = Wong | first4 = MP. | title = Germ cell tumour as a diagnostic pitfall of metastatic carcinoma. | journal = J Clin Pathol | volume = 49 | issue = 3 | pages = 223-5 | month = Mar | year = 1996 | doi = | PMID = 8675733 }}</ref> | ||
*Vimentin. | *[[Vimentin]]. | ||
* | *[[Glypican 3]] +ve -- [[yolk sac tumour]]. | ||
*A1A +ve -- yolk sac tumour. | **Others: A1A +ve -- yolk sac tumour, AFP +ve -- yolk sac tumour. | ||
==Sign out== | ==Sign out== | ||