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| *[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)]. |
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| ==Yolk sac tumour== | | ==Yolk sac tumour== |
| ===General===
| | {{Main|Yolk sac tumour}} |
| *Tumour also known as ''endodermal sinus tumour''.
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| ===Epidemiology===
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| *Most common GCT in infants and young boys. | | *Most common GCT in infants and young boys. |
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| *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> |
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| Image:
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| *[http://www.webpathology.com/image.asp?case=34&n=5 Schiller-Duval body (webpathology.com)].
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|
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| Variants:
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| *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>
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| **Vaguely resembles liver.
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| ***Hyaline globules (light red well-circumscribed globs).
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| ***Bile canaculi.
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| *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>
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| **Vaguely resembles ''seminoma''.
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| Image:
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| *[http://webpathology.com/image.asp?case=34&n=6 Hepatoid Pattern].
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|
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| ===IHC===
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| *AFP +ve.
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| *Glypican 3 +ve.
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| **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>
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| *Alpha-1 AT +ve.
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| *Cytokeratin +ve. ???
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|
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| ===DDx===
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| *Embryonal carcinoma.
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| ==Embryonal carcinoma== | | ==Embryonal carcinoma== |
| ===General===
| | {{Main|Embryonal carcinoma}} |
| *Affects young adults.
| | These often look like a poorly differentiated carcinoma. |
| **May be seen in women.
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| ===Microscopic===
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| Features:<ref name=Ref_GUP549>{{Ref GUP|549}}</ref>
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| #Nucleoli - '''key feature'''.
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| #Vesicular nuclei (clear, empty appearing nuclei) - '''key feature'''.
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| #Nuclei overlap.
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| #[[Necrosis]] - common.
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| #*Not commonly present in seminoma.
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| #Indistinct cell borders
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| #Mitoses - common.
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| #Variable architecture:
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| #*Tubulopapillary.
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| #*Glandular.
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| #*Solid.
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| #*Embryoid bodies - ball of cells in surrounded by empty space on three sides.
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| Notes:
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| *Cytoplasmic staining variable (eosinophilic to basophilic).
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| Images:
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| *Set 1:
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| **[http://commons.wikimedia.org/wiki/File:Embryonal_carcinoma_-_very_high_mag_-_cropped.jpg Embryonal carcinoma - very high mag. - cropped (WC)].
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| **[http://commons.wikimedia.org/wiki/File:Embryonal_carcinoma_-_high_mag.jpg Embryonal carcinoma - high mag. (WC)].
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| *Set 2:
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| **[http://commons.wikimedia.org/wiki/File:Embryonal_carcinoma_high_mag.jpg Embryonal carcinoma - high mag. (WC)].
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| **[http://commons.wikimedia.org/wiki/File:Embryonal_carcinoma_intermed_mag.jpg Embryonal carcinoma - intermed. mag. (WC)].
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| **[http://commons.wikimedia.org/wiki/File:Embryonal_carcinoma_low_mag.jpg Embryonal carcinoma - low mag. (WC)].
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| ===DDx===
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| *Yolk sac tumour.
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| ===IHC===
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| *AE1/AE3 +ve.
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| *CD30 +ve.
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| ==Choriocarcinoma== | | ==Choriocarcinoma== |
| ===Clinical===
| | {{Main|Choriocarcinoma}} |
| *Aggressive clinical course.
| | There are aggressive tumours. |
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| ===Microscopy===
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| *Syncytiotrophoblasts:
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| **Large + many irreg. or lobular hyperchromatic nuclei.
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| **Eosinophilic vacuolated cytoplasm (contains hCG).
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| *'''C'''ytotrophoblasts:
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| **'''C'''lear cytoplasm.
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| **Polygonal shaped cells in cords/masses.
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| **Distinct cell borders.
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| **Single uniform nucleus.
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| *+/-Hemorrhage.
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| *+/-Necrosis.
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| Image(s):
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| *[http://www.webpathology.com/image.asp?case=36&n=1 Choriocarcinoma (webpathology.com)]
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| Notes:
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| *See: ''[[Chorionic villi]]''.
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| ===IHC===
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| *beta-hCG +ve.
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|
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| ==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:
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| *#*Skin, CNS.
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| *#Mesoderm:
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| *#*Muscle, bone, connective tissue, blood.
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| *#Ectoderm:
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| *#*Internal organs.
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| ===Classification===
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| *Divided into:
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| **Mature.
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| **Immature.
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| ===Immature===
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| *Immature if neural tissue is present:<ref>RS. 2 May 2010.</ref>
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| **Vaguely resembles pseudostratified respiratory epithelium.
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| *Islands of small hyperchromatic cells - "blastema".
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| *+/-Cartilage.
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| *+/-Adipocytes.
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| *+/-Colonic type mucosa.
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| *+/-Stratified squamous epithelium (skin).
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| Images:
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| *[http://commons.wikimedia.org/wiki/File:Immature_teratoma_high_mag.jpg Primitive neuroepithelium - high mag. (WC)].
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| *[http://commons.wikimedia.org/wiki/File:Primitive_neuroepithelium_intermed_mag.jpg Primitive neuroepithelium - intermed mag. (WC)]
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| *[http://commons.wikimedia.org/wiki/File:Teratoma_intermed_mag.jpg Teratoma - mature components (WC)].
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| Other images:
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| *[http://www.webpathology.com/image.asp?n=5&Case=35 Immature teratoma - myxomatous stroma (webpathology.com)].
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| *[http://www.webpathology.com/image.asp?n=6&Case=35 Immature teratoma - blastema (webpathology.com)].
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| *[http://www.webpathology.com/image.asp?n=7&Case=35 Immature teratoma - primitive neuroepithelium (webpathology.com)].
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| *[http://www.pathconsultddx.com/pathCon/largeImage?pii=S1559-8675%2806%2970278-9&figureId=fig2 Immature teratoma - primitive neuroepithelium (pathconsultddx.com)].
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| *[http://moon.ouhsc.edu/kfung/jty1/opaq/PathQuiz/N0C001-PQ01-M.htm Immature teratoma - primitive neuroepithelium (ouhsc.edu)].
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| ===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>
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| *G0 - mature teratoma; no immature neuroepithelium.
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| *G1 - less than one lower power field ([[LPF]]) of immature neuroepithelium; LPF defined field at 4X magnification.
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| *G2 - 1-3 LPFs.
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| *G3 - more than 3 LPFs.
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| Note:
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| *LPF not adequately defined - see [[LPFitis]]. Same BS as HPF.
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| ===IHC (immature)===
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| Features:
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| *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>
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| **Neuron-specific enolase (NSE) +ve.
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| **Neuron-specific B tubulin +ve.
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| **Synaptophysin +ve.
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|
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| ==Leydig cell tumour== | | ==Leydig cell tumour== |