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'''Adult granulosa cell tumour''' is an [[ovarian tumour]]. It is also known as '''granulosa cell tumour'''. It dhould '''not''' be confused with the ''[[granular cell tumour]]''. | |||
Ideally, it should be called ''adult granulosa cell tumour'' to avoid confusion with ''[[juvenile granulosa cell tumour]]''. | |||
==General== | |||
*May secrete estrogen. | |||
**May present with endometrial pathology, e.g. [[endometrial hyperplasia]] ''or'' endometrioid [[endometrial carcinoma]]. | |||
**Occasionally secrete antrogens lead to virilization.<ref name=pmid19062005>{{Cite journal | last1 = Patel | first1 = SS. | last2 = Carrick | first2 = KS. | last3 = Carr | first3 = BR. | title = Virilization persists in a woman with an androgen-secreting granulosa cell tumor. | journal = Fertil Steril | volume = 91 | issue = 3 | pages = 933.e13-5 | month = Mar | year = 2009 | doi = 10.1016/j.fertnstert.2008.10.038 | PMID = 19062005 }}</ref> | |||
Note: | |||
*Normal granulosa cells convert androgen from the theca cells to estrogen and/or progesterone.<ref name=pmid15541573>{{Cite journal | last1 = Havelock | first1 = JC. | last2 = Rainey | first2 = WE. | last3 = Carr | first3 = BR. | title = Ovarian granulosa cell lines. | journal = Mol Cell Endocrinol | volume = 228 | issue = 1-2 | pages = 67-78 | month = Dec | year = 2004 | doi = 10.1016/j.mce.2004.04.018 | PMID = 15541573 }}</ref> | |||
==Gross== | |||
*Classically solid. | |||
==Microscopic== | |||
Features: | |||
* Classic appearance includes gland-like structures filled with acidophilic material (Call-Exner bodies). | |||
* Small cuboidal to polygonal cell in sheets ''or'' strands ''or'' cords. | |||
* Nuclear grooves. | |||
Note: | |||
*There is a "10% rule" -- if less than 10% of a SCST is granulosa cells... it isn't granulosa cell tumour. | |||
*Juvenile variant of GCT has more nuclear pleomorphism. | |||
DDx:<ref>{{Cite journal | last1 = Kommoss | first1 = S. | last2 = Anglesio | first2 = MS. | last3 = Mackenzie | first3 = R. | last4 = Yang | first4 = W. | last5 = Senz | first5 = J. | last6 = Ho | first6 = J. | last7 = Bell | first7 = L. | last8 = Lee | first8 = S. | last9 = Lorette | first9 = J. | title = FOXL2 molecular testing in ovarian neoplasms: diagnostic approach and procedural guidelines. | journal = Mod Pathol | volume = 26 | issue = 6 | pages = 860-7 | month = Jun | year = 2013 | doi = 10.1038/modpathol.2012.226 | PMID = 23348906 }}</ref> | |||
* [[Urothelial cell carcinoma]] (UCC). | |||
** UCC usually has extensive necrosis. | |||
* [[Brenner tumour]]. | |||
* [[Sertoli cell tumour]]. | |||
* [[Sertoli-Leydig cell tumour]]. | |||
* [[Endometrial stromal sarcoma]]. | |||
===Images=== | |||
<gallery> | |||
Image:Granulosa_cell_tumour1.jpg | Granulosa cell tumour - low mag. (WC) | |||
Image:Granulosa_cell_tumour2.jpg | Granulosa cell tumour - high mag. (WC) | |||
</gallery> | |||
==IHC== | |||
* Inhibin positive.<ref name=Ref_PBoD1102>{{Ref PBoD|1102}}</ref> | |||
** Inhibin negative in ''[[Brenner tumour]]''. | |||
*Calretinin +ve. | |||
==Molecular== | |||
:Currently not used for diagnosis. | |||
*FOXL2 point mutation<ref name=pmid22240241 >{{Cite journal | last1 = Jamieson | first1 = S. | last2 = Fuller | first2 = PJ. | title = Molecular pathogenesis of granulosa cell tumors of the ovary. | journal = Endocr Rev | volume = 33 | issue = 1 | pages = 109-44 | month = Feb | year = 2012 | doi = 10.1210/er.2011-0014 | PMID = 22240241 }}</ref> seen in 86 of 89 tumours.<ref name=pmid19516027>{{Cite journal | last1 = Shah | first1 = SP. | last2 = Köbel | first2 = M. | last3 = Senz | first3 = J. | last4 = Morin | first4 = RD. | last5 = Clarke | first5 = BA. | last6 = Wiegand | first6 = KC. | last7 = Leung | first7 = G. | last8 = Zayed | first8 = A. | last9 = Mehl | first9 = E. | title = Mutation of FOXL2 in granulosa-cell tumors of the ovary. | journal = N Engl J Med | volume = 360 | issue = 26 | pages = 2719-29 | month = Jun | year = 2009 | doi = 10.1056/NEJMoa0902542 | PMID = 19516027 }}</ref> | |||
==See also== | |||
*[[Ovarian tumours]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Ovarian tumours]] | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||