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Difference between revisions of "Germ cell tumours"
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This article covers '''germ cell tumours''' which classicaly arise in the gonads ([[ovary]], [[testis]]). They also show-up in [[neuropathology]] and in the mediastinum. | This article covers '''germ cell tumours''' which classicaly arise in the gonads ([[ovary]], [[testis]]). They also show-up in [[neuropathology]] and in the mediastinum. | ||
==Overview== | |||
*Germ cell tumours (GCTs). | |||
**Intratubular germ cell neoplasia. | |||
**Germinoma/Seminoma/Dysgerminoma. | |||
**Yolk sac tumour (endodermal sinus tumour). | |||
**Embryonal carcinoma. | |||
**Choriocarcinoma. | |||
**Teratoma. | |||
**Mixed GCT - 60% of GCTs are mixed. | |||
***Common combinations: | |||
***# teratoma + embryonal carcinoma + endodermal sinus tumour (yolk sac tumour) (TEE). | |||
***# seminoma + embryonal (SE). | |||
***# embryonal + teratoma (TE). | |||
===IHC for GCTs=== | |||
ABCDs of GCTs: | |||
*AFP - yolk sac tumour. | |||
*Beta-hCG - choriocarcinoma. | |||
*CD30 - embryonal carcinoma. | |||
*D2-40 - seminoma. | |||
===Tabular summary of GCTs=== | |||
{| class="wikitable" | |||
!| Tumour | |||
!| Key feature | |||
!| Microscopic | |||
!| IHC | |||
!| Other | |||
!| Image | |||
|- | |||
| Intratubular germ cell neoplasia (ITGCN) | |||
| nests of small fried egg cells | |||
| large central nucleus, clear <br>cytoplasm, squared-off nuclear membrane, nucleoli<ref name=Ref_GUP538>{{Ref GUP|538}}</ref> | |||
| CD117 | |||
| appearance similar to seminoma | |||
| [http://commons.wikimedia.org/wiki/File:Intratubular_germ_cell_neoplasia_high_mag.jpg], [http://commons.wikimedia.org/wiki/File:Intratubular_germ_cell_neoplasia_high_mag_cropped.jpg] | |||
|- | |||
| Germinoma / Seminoma / Dysgerminoma | |||
| fried egg cells | |||
| fried egg-like cells (central nucleus, clear <br>cytoplasm) with squared-off nuclear <br>membrane, nucleoli, lymphocytic infiltrate, granulomata,<br>syncytiotrophoblastic giant cells<ref name=Ref_GUP542>{{Ref GUP|542}}</ref> | |||
| D2-40 | |||
| seminoma = male version of this tumour; dysgerminoma = female version of this tumour | |||
| [http://commons.wikimedia.org/wiki/File:Seminoma_high_mag.jpg], [http://commons.wikimedia.org/wiki/File:Seminoma_intermed_mag.jpg] | |||
|- | |||
| [[Yolk sac tumour]] (endodermal sinus tumour) | |||
| Schiller-Duval bodies | |||
| Schiller-Duval b. = central blood vessel surrounded by epithelial-like cells a space and more epithelial-like cells, variable arch. | |||
| AFP | |||
| patterns: microcystic, solid, hepatoid | |||
| [http://webpathology.com/image.asp?case=34&n=6 hepatoid YST] | |||
|- | |||
| [[Embryonal carcinoma]] | |||
| prominent nucleoli, vescicular nuclei | |||
| var. arch.: tubulopapillary, glandular, solid, embryoid bodies (ball of cells in surrounded by empty space on three sides), +/-nuclear overlap, mitoses common | |||
| CD30 | |||
| usu. part of a mixed GCT | |||
| [http://commons.wikimedia.org/wiki/File:Embryonal_carcinoma_intermed_mag.jpg], [http://www.webpathology.com/image.asp?case=33&n=1], [http://www.webpathology.com/image.asp?n=4&Case=37] | |||
|- | |||
| [[Choriocarcinoma]] | |||
| marked nuclear atypia | |||
| cells with clear cytoplasm (cytotrophoblast), multinucleated cells (syncytiotrophoblast) | |||
| beta-hCG | |||
| other | |||
| [http://www.webpathology.com/image.asp?case=36&n=1] | |||
|- | |||
| [[Teratoma]], immature | |||
| primitive neuroepithelium | |||
| pseudostratified epithelium in rosettes (gland-like arrangement) | |||
| None | |||
| teratoma are always malignant in males | |||
| [http://commons.wikimedia.org/wiki/File:Primitive_neuroepithelium_intermed_mag.jpg] | |||
|- | |||
| Mixed germ cell tumour | |||
| NA | |||
| common combinations: teratoma + embryonal carcinoma + endodermal sinus tumour (yolk sac tumour) (TEE); seminoma + embryonal (SE); embryonal + teratoma (TE) | |||
| NA | |||
| - | |||
| - | |||
|} | |||
==Germinoma== | ==Germinoma== | ||