Difference between revisions of "Sertoli-Leydig cell tumour"

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*Well differentiated -  
*Well differentiated -  
**Mature Sertoli cells line form tubules that grow in a fibrous stroma containing clusters of Leydig
**Mature Sertoli cells form tubules
**Stroma is fibrous and contains clusters of Leydig
cells
cells
*Intermediate to poorly differentiated -   
*Intermediate to poorly differentiated -   
**A more disorganized, more cellular tumor with less mature Sertoli cells growing in trabeculae and nests.  Some tubule formation, either round or retiform. Leydig cells, either singly or in clusters, are present in a cellular stroma.
**A more disorganized, more cellular, 'bluer' tumor
**Less mature Sertoli cells growing in trabeculae and nests with some tubule formation, either round or retiform.
**Leydig cells, either singly or in clusters, are present in an immature, cellular stroma.


DDx:
DDx:
*[[Endometrioid carcinoma of the ovary]].
*[[Endometrioid carcinoma of the ovary]] (sertoliform variant) - should be positive for EMA, negative for inhibin and calretinin.
*Luteinized [[adult granulosa cell tumour]] - super rare, 50% of cell with eosinophilic cytoplasm, other findings of granulosa cell tumour, e.g. Call-Exner bodies.<ref name=pmid21804396>{{Cite journal  | last1 = Ganesan | first1 = R. | last2 = Hirschowitz | first2 = L. | last3 = Baltrušaitytė | first3 = I. | last4 = McCluggage | first4 = WG. | title = Luteinized adult granulosa cell tumor--a series of 9 cases: revisiting a rare variant of adult granulosa cell tumor. | journal = Int J Gynecol Pathol | volume = 30 | issue = 5 | pages = 452-9 | month = Sep | year = 2011 | doi = 10.1097/PGP.0b013e318214b17f | PMID = 21804396 }}</ref>
*Luteinized [[adult granulosa cell tumour]] - super rare, 50% of cell with eosinophilic cytoplasm, other findings of granulosa cell tumour, e.g. Call-Exner bodies.<ref name=pmid21804396>{{Cite journal  | last1 = Ganesan | first1 = R. | last2 = Hirschowitz | first2 = L. | last3 = Baltrušaitytė | first3 = I. | last4 = McCluggage | first4 = WG. | title = Luteinized adult granulosa cell tumor--a series of 9 cases: revisiting a rare variant of adult granulosa cell tumor. | journal = Int J Gynecol Pathol | volume = 30 | issue = 5 | pages = 452-9 | month = Sep | year = 2011 | doi = 10.1097/PGP.0b013e318214b17f | PMID = 21804396 }}</ref>


Revision as of 10:38, 21 March 2015

Sertoli-Leydig cell tumour, also Sertoli-Leydig tumour, is a rare tumour of the gonad in the sex cord-stromal group of tumours.

General

  • Sertoli and leydig cells are normal in the testis.
  • Poorly differentiated tumours have sarcomatous features.[1]
  • May present with masculinization (virilization).[2]

Microscopic

Features:

  1. Sertoli or Leydig cells.[1]
    • Leydig cells:
      • Polygonal pink cells
      • Abundant solid or somewhat granular eosinophilic cytoplasm.
      • Round nuclei with fine chromatin and a small or indistinct nucleolus.
      • Often in small clusters ~ 5-25 cells/cluster.
    • Sertoli cells:
      • Pale/clear vacuolated cytoplasm.
      • Irregular nuclei with irregular/vacuolated-appearing chromatin.
      • Architecture: tubules, cords or sheets.
  2. Stroma.
  3. +/- Sarcomatous features (mucinous glands, bone, cartilage).
  • Well differentiated -
    • Mature Sertoli cells form tubules
    • Stroma is fibrous and contains clusters of Leydig

cells

  • Intermediate to poorly differentiated -
    • A more disorganized, more cellular, 'bluer' tumor
    • Less mature Sertoli cells growing in trabeculae and nests with some tubule formation, either round or retiform.
    • Leydig cells, either singly or in clusters, are present in an immature, cellular stroma.

DDx:

Images

  • Sertoli-Leydig cell tumour - intermed. mag. (WC)

  • Sertoli-Leydig cell tumour - high mag. (WC)

  • Sertoli-Leydig cell tumour - very high mag. (WC)

www:

IHC

Features:[4]

  • AE1/AE3 +ve
  • Inhibin +ve
  • WT-1 +ve.
  • Melan A (MART-1) +ve - marks the Leydig component.
  • Vimentin +ve.[5]
  • Calretinin +ve.
  • CD99 +ve.

Others:[5]

  • CD34 -ve.
  • EMA -ve.

Pan-keratins and AE1/AE3 may mark granulosa cell tumors and Sertoli cell tumors causing confusion with adenocarcinoma. EMA is a better marker to exclude an epithelial tumor as EMA is negative in sex cord-stromal tumors. Adding complexity, endometrioid adenocarcinomas may occasionally weakly express inhibin, calretinin or WT-1.

See also

References

  1. ↑ 1.0 1.1 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. pp. 1103. ISBN 0-7216-0187-1.
  2. ↑ Xiao, H.; Li, B.; Zuo, J.; Feng, X.; Li, X.; Zhang, R.; Wu, L. (Mar 2013). "Ovarian Sertoli-Leydig cell tumor: a report of seven cases and a review of the literature.". Gynecol Endocrinol 29 (3): 192-5. doi:10.3109/09513590.2012.738723. PMID 23173550.
  3. ↑ Ganesan, R.; Hirschowitz, L.; Baltrušaitytė, I.; McCluggage, WG. (Sep 2011). "Luteinized adult granulosa cell tumor--a series of 9 cases: revisiting a rare variant of adult granulosa cell tumor.". Int J Gynecol Pathol 30 (5): 452-9. doi:10.1097/PGP.0b013e318214b17f. PMID 21804396.
  4. ↑ Zhao, C.; Vinh, TN.; McManus, K.; Dabbs, D.; Barner, R.; Vang, R. (Mar 2009). "Identification of the most sensitive and robust immunohistochemical markers in different categories of ovarian sex cord-stromal tumors.". Am J Surg Pathol 33 (3): 354-66. doi:10.1097/PAS.0b013e318188373d. PMID 19033865.
  5. ↑ 5.0 5.1 Kondi-Pafiti, A.; Grapsa, D.; Kairi-Vassilatou, E.; Carvounis, E.; Hasiakos, D.; Kontogianni, K.; Fotiou, S. (2010). "Granulosa cell tumors of the ovary: a clinicopathologic and immunohistochemical study of 21 cases.". Eur J Gynaecol Oncol 31 (1): 94-8. PMID 20349790.
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