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Difference between revisions of "Leydig cell tumour"
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| Caption = Leydig cell tumour. [[H&E stain]]. | | Caption = Leydig cell tumour. [[H&E stain]]. | ||
| Synonyms = interstitial cell tumour | |||
| Micro = cytoplasmic vacuolization, cytoplasm -- clear to eosinophilic, +/-''Reinke crystals'' (cylindrical crystalloid -- eosinophilic cytoplasmic bodies), +/-[[nucleoli]] common, round nuclei | | Micro = cytoplasmic vacuolization, cytoplasm -- clear to eosinophilic, +/-''Reinke crystals'' (cylindrical crystalloid -- eosinophilic cytoplasmic bodies), +/-[[nucleoli]] common, round nuclei | ||
| Subtypes = | | Subtypes = benign (common), malignant (rare) | ||
| LMDDx = [[spermatocytic | | LMDDx = [[spermatocytic tumour]] (testis only), [[pregnancy luteoma]] (females only), [[Sertoli-Leydig cell tumour]], [[Leydig cell hyperplasia]] | ||
| Stains = | | Stains = | ||
| IHC = inhibin-alpha +ve, calretinin +ve, melan A +ve | | IHC = inhibin-alpha +ve, calretinin +ve, melan A +ve | ||
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| Rads = | | Rads = | ||
| Endoscopy = | | Endoscopy = | ||
| Prognosis = usu. benign | | Prognosis = usu. benign, occasionally malignant | ||
| Other = | | Other = | ||
| ClinDDx = other testicular tumours | | ClinDDx = other testicular tumours | ||
}} | }} | ||
'''Leydig cell tumour''', also known as '''interstitial cell tumour''', is an uncommon benign sex cord-stromal tumour, typically seen in the [[testis]]. | '''Leydig cell tumour''' (abbreviated '''LCT'''), also known as '''interstitial cell tumour''', is an uncommon benign sex cord-stromal tumour, typically seen in the [[testis]]. | ||
''Interstitial cell tumour'' should '''not''' be confused with ''[[renomedullary interstitial cell tumour]]''. | ''Interstitial cell tumour'' should '''not''' be confused with ''[[renomedullary interstitial cell tumour]]''. | ||
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*Nucleoli common. | *Nucleoli common. | ||
*Round nuclei. | *Round nuclei. | ||
Features of malignancy in Leydig cell tumours:<ref name=pmid21691571>{{Cite journal | last1 = Vasilakaki | first1 = T. | last2 = Michalis | first2 = L. | last3 = Skafida | first3 = E. | last4 = Arkoumani | first4 = E. | last5 = Delliou | first5 = E. | last6 = Grammatoglou | first6 = X. | last7 = Kontovourkis | first7 = P. | last8 = Papamichail | first8 = V. | last9 = Stamatiou | first9 = K. | title = An unusual case of unilateral malignant leydig cell tumour of the testis. | journal = Case Rep Oncol | volume = 4 | issue = 1 | pages = 132-5 | month = Jan | year = 2011 | doi = 10.1159/000326800 | PMID = 21691571 }}</ref><ref name=pmid9808128>{{Cite journal | last1 = Cheville | first1 = JC. | last2 = Sebo | first2 = TJ. | last3 = Lager | first3 = DJ. | last4 = Bostwick | first4 = DG. | last5 = Farrow | first5 = GM. | title = Leydig cell tumor of the testis: a clinicopathologic, DNA content, and MIB-1 comparison of nonmetastasizing and metastasizing tumors. | journal = Am J Surg Pathol | volume = 22 | issue = 11 | pages = 1361-7 | month = Nov | year = 1998 | doi = | PMID = 9808128 }}</ref> | |||
*Large size (4.7 cm in metastatic LCT vs. 2.6 cm in nonmetastatic LCT<ref name=pmid9808128/>). | |||
*Infiltrative margins. | |||
*Lymphovascular invasion. | |||
*Necrosis. | |||
*Nuclear atypia. | |||
*Mitoses (>3/10 HPF). | |||
*High Ki-67 (18.6% in metastatic LCT vs. 1.2% cm in nonmetastatic LCT<ref name=pmid9808128/>). | |||
DDx: | DDx: | ||
*[[Spermatocytic | *[[Spermatocytic tumour]] (previously ''spermatocytic seminoma'') - may have eosinophilic cytoplasm. | ||
*[[Pregnancy luteoma]] - occurs during pregnancy, as the name implies. | *[[Pregnancy luteoma]] - occurs during pregnancy, as the name implies. | ||
*Leydig cell hyperplasia. | *[[Leydig cell hyperplasia]]. | ||
*[[Granular cell tumour]].<ref name=pmid17284120/> | *[[Granular cell tumour]].<ref name=pmid17284120/> | ||
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www: | www: | ||
*[http://path.upmc.edu/cases/case404.html Leydig cell tumour - several images (upmc.edu)]. | *[http://path.upmc.edu/cases/case404.html Leydig cell tumour - several images (upmc.edu)]. | ||
*[http://www.webpathology.com/image.asp?case=38&n=3 Reinke crystals (webpathology.com)]. | |||
*[https://www.pinterest.com/pin/520447300659777928/ Reinke crystals (pinterest.com)]. | |||
*[https://www.pinterest.com/pin/499829258616698163/ Reinke crystals (pinterest.com)]. (???) | |||
==IHC== | ==IHC== | ||
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**Expressed in [[melanoma]], [[adrenal gland|adrenal tissue]], steroid-secreting tumours. | **Expressed in [[melanoma]], [[adrenal gland|adrenal tissue]], steroid-secreting tumours. | ||
*Vimentin +ve.<ref name=pmid17284120/> | *Vimentin +ve.<ref name=pmid17284120/> | ||
*[[SALL4]] -ve (10 of 10 cases).<ref name=pmid19390421>{{cite journal |authors=Cao D, Li J, Guo CC, Allan RW, Humphrey PA |title=SALL4 is a novel diagnostic marker for testicular germ cell tumors |journal=Am J Surg Pathol |volume=33 |issue=7 |pages=1065–77 |date=July 2009 |pmid=19390421 |doi=10.1097/PAS.0b013e3181a13eef |url=}}</ref> | |||
==Sign out== | |||
<pre> | |||
Mass of Right Testicle, Radical Orchiectomy: | |||
- Leydig cell tumour. | |||
Comment: | |||
The tumour consists of polygonal cells with abundant eosinophilic | |||
cytoplasm, round nuclei with prominent nucleoli. | |||
Features suggestive of malignancy are absent. | |||
The tumour stains with calretinin, Melan A and inhibin. It is | |||
negative for AE1/AE3, and OCT4. This supports the diagnosis | |||
of Leydig cell tumour. | |||
</pre> | |||
==See also== | ==See also== | ||