Difference between revisions of "Leydig cell tumour"

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| Width      =
| Width      =
| 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 seminoma]] (testis only), [[pregnancy luteoma]] (females only), [[Sertoli-Leydig cell tumour]]
| 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 seminoma]] - may have eosinophilic cytoplasm.
*[[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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**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>


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Comment:
Comment:
The tumour consists of polygonal cells with abundant eosinophilic
The tumour consists of polygonal cells with abundant eosinophilic
cytoplasm, round nuclei with prominent nucleoli.
cytoplasm, round nuclei with prominent nucleoli.
 
Features suggestive of malignancy are absent.


The tumour stains with calretinin, Melan A and inhibin. It is
The tumour stains with calretinin, Melan A and inhibin. It is
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