May 20, 20 seminoma is the most common type of pure germ cell tumor gct of the testicles and accounts for around half of all cases of testicular cancer. Full text get a printable copy pdf file of the complete article 687k, or click on a page image below to browse page by page. Read and know all about this type of cancer, including its possible causes, symptoms, diagnosis, treatment options and more. The size of the primary tumor was significantly correlated with the pt category, as was the presence of tumor invasion of small vessels.
A retrospective analysis of 80 cases of seminomas treated at the university of louisville radiation center from 1958 to 1979 has been done. Best practices recommendations in the application of immunohistochemistry in testicular tumors. Spermatocytic seminomas are uncommon tumours occurring in patients older than those with classic seminoma. They seldom occur in childhood, young adults, or in patients over 70 years of age. Necrotic seminoma of the testisflorentine et al 205. Relapse in % seminoma pts and 19% non seminoma pts. Jan 07, 2009 it is a rare tumor, with a frequency varying from 1. Like conventional spermatocytic seminoma, the anaplastic variant consisted of tumor cells of various sizes with filamentous or granular chromatin. Difficult differential diagnoses in testicular pathology. Patients tend to present at more advanced stages than those with classic seminoma, but stage prognosis is similar. This program was designed to help urology residents and fellows familiarize themselves with the.
Anaplastic seminomas are distinguished from classic seminomas by greater nuclear atypia and a higher mitotic rate. Over a 28 year period, 77 patients with early stage anaplastic seminoma of the testis were treated by orchiectomy and lymphatic irradiation at three army medical centers. At the time of presentation anaplastic seminoma has similar prognosis stage for. Spermatocytic tumor accounts for approximately 1% of testicular germ cell tumors gct and is thought to be derived from.
Printable germ cell tumors of the mediastinum thymus. Prognosis is stage dependent with excellent 5 year survival when clinical stage 1. It was first recognized and described by masson le seminome spermatocytaire in 1946. Classification and general considerations of thyroid. Seminoma is a germinal cell tumor composed of uniform cells with glycogenrich cytoplasm and large irregular nucleus with one or several distinct nucleoli and marked cell boundaries. Coronal t2weighted a and contrastenhanced t1weighted b images show large inhomogeneous right testicular mass invading ipsilateral epididymis long arrow. Although this tumor appears to behave more aggressively than classical seminoma, presenting with earlier metastases, it has the same prognosis when staging is taken into consideration. This is a classic testicular seminoma, highpower view, from a 37yearold man with a painless mass in his right testis. Anaplastic definition of anaplastic by the free dictionary. A cytogenetic hybrid article pdf available june 2014 with 159 reads how we measure reads. Between 1986 and 2006, seven anaplastic seminoma patients were staged and treated at the northern israel oncology center. It is a malignant neoplasm and is one of the most treatable and curable cancers, with a survival rate above 95% if discovered in early stages.
The 10year survival rate was 100% among patients with seminoma histology, 90. Anaplastic seminoma is observed in 5%15% of patients with seminomas. Anaplastic seminoma and spermatocytic seminomaa retrospective analysis. We report a case of a 56yearold male with an anaplastic variant of spermatocytic seminoma of the left testis. Anaplastic seminoma anaplastic seminoma kademian, michael. A seminoma is a germ cell tumor of the testicle or, more rarely, the mediastinum or other extragonadal locations. Figure 72 colonic polyp gross appearance of several colonic polyps. Hiroshi katoh, keishi yamashita, takumo enomoto and.
Levels of serum betahuman chorionic gonadotropin and alphafetoprotein were within the reference range, and the metastatic workup findings were negative. For patients with stage i anaplastic seminoma no survival advantage can be demonstrated. Earlier thinking was that tumor cells were reverting to an earlier embryologic state. Epsteinbarr virus ebv infection of the tumor cells in primary systemic and cutaneous alcl of tnullcell type is rare or absent. Diagnostic pitfalls in the histopathological diagnosis of. Histology histology description histology behavior histology behavior description c000c006,c008c009 lip 800 neoplasm 80003 neoplasm, malignant. Among the non seminomatous germ cell tumor, embryonal carcinoma comprised of 8 cases 16 %. The cells are more cohesive than they are in seminoma and may be arranged in trabecular, glandular, papillary, and solid patterns. The cytomorphology of anaplastic large cell lymphoma alcl is distinctive yet variable. This document supersedes the 2007 edition, dataset for histopathology. Whereas classical tumour patterns are well described and recognized, the relative rarity of some tumour types can lead to diagnostic. Seminoma causes, symptoms, diagnosis, treatment and prognosis. These results suggest that anaplastic seminoma has a poorer prognosis than typical seminoma even when the diseeses are compared stage for stage.
Seminoma with high mitotic rate, also known as anaplastic or atypical. In both studies, the small cell variant histology accounted for approximately 30% of patients. The reproducibility of alcl on the morphological ground is poor and at times it may mimic other nonlymphoid malignancies. Histopathology is as described for classic seminoma but with increased mitotic figures. It is very rare for patients with primary mediastinal seminoma to present initially with a neck mass.
Patients with anaplastic seminoma have been reported to have a poorer prognosis than those with typical seminoma,5 although recently this premise has been challenged. Anaplasia referring to increased mitoses and pleomorphism within a. Testicular anaplastic seminoma, which has a high mitotic activtiy, is regarded aa more malignant than typical seminoma, although its prognosis is still unclear. Treatment is based upon accurate histological diagnosis. It is a rare tumor, with a frequency varying from 1. Ulbright tm, tickoo sk, berney dm, srigley jr august 2014. Active surveillance for csi testis cancer leads to excellent outcomes. Its prognosis is generally excellent and many therapeutic options are available, especially in stage i tumors. It most commonly occurs in people over the age of 60 years. It is a distinct category of large cell lymphomas that shows strong expression of cd30.
May 15, 2007 testicular germ cell tumours non seminomatous germ cell tumours pathology mini tutorial duration. Mediastinal seminoma presenting as a neck mass falsely. Therapyresistant metastasizing anaplastic spermatocytic seminoma. However, we now realize they go to more of a stem cell state.
Department of surgery, kitasato university school of medicine, japan. Nov 23, 2018 by immunohistochemistry, the tumor cells were immunoreactive with sall4, plap and oct34, compatible with malignant germ cell tumor, seminomatous type. Standards and datasets for reporting cancers dataset for the. Among the nonseminomatous germ cell tumor, embryonal carcinoma comprised of 8 cases 16%. Anaplastic spermatocytic seminoma is a rare variant of the conventional spermatocytic seminoma, with only 6 cases reported up to now. A practical approach to the reporting of germ cell tumours of. Anaplastic large cell lymphoma and some mediastinal large b cell lymphomas. Epidemiology testicular cancer represents 1% of male neoplasms and 5% of tm 12% bilateral, and the predominant is germ cell tm 9095% peak incidence.
Eight cases have been treated with a diagnosis of anaplastic seminoma. Mri in the histologic characterization of testicular. Testicular seminoma originates in the germinal epithelium of the seminiferous tubules. Lymphoepitheliomalike carcinoma can be distinguished from seminoma and embryonal carcinoma as it is ema positive and negative for sall4 and oct34. Knowing the type helps your doctor decide which treatment you need. Pdf therapyresistant metastasizing anaplastic spermatocytic. Anaplastic spermatocytic seminoma is a rare variant of the conventional. Population based incidence and age distribution of spermatocytic seminoma. Thyroid cancer is the most common malignancy in endocrine system, composed of. Although testicular germ cell tumours are relatively uncommon they are particularly important as they tend to affect young men and even the advanced metastatic form of the disease has a high cure rate. Classification and general considerations of thyroid cancer. Fine needle aspiration fna of this neck mass can lead to misinterpretation of findings due to similarities in cytological features between malignant germ cell tumors and other undifferentiated malignant neoplasms and the diagnosis. Feb 10, 20 stage iii seminoma chemotherapy is the standard of care role of radiation therapy is very limited and is used only in cases of relapse chemotherapy used is.
Sep 05, 2019 this is a classic testicular seminoma, highpower view, from a 37yearold man with a painless mass in his right testis. The tumours are most prevalent in the fourth and fifth decades occurring at a somewhat later age than teratomas. Clements, joseph c mcleod, david g sorgen, stephen d cardinale, francis s. D this is an example of a spermatocytic tumor spermatocytic seminoma. Molecular and genetic features of atc are widely heterogeneous as well and many efforts have been made to find a common profile in order to clarify its cancerogenetic process.
The anaplastic variant of spermatocytic seminoma is rare, and only one report describing four cases of this variant has been reported to date. The survival for patients with anaplastic histology or with elevated b subunit of human chorionic gonadotropin was not significantly different from that of typical seminoma. Seminoma and its variants histologic designation clinical features of each histologic type. Mar 16, 2020 webpathology is a free educational resource with 10328 high quality pathology images of benign and malignant neoplasms and related entities. The term anaplastic seminoma has been proposed in the past for tumours with a particularly aggressive look and a high mitotic count.
February 22, 2011, neoplasia 1 lecture duke university. In our experience, 2 variants of seminoma may closely mimic embryonal. Anaplastic seminoma and spermatocytic seminoma a retrospective analysis. An aggressive variant with a poor response to novel therapies nischala ammannagari,1 kimberly celotto,1 vishala neppalli,2 kelvin lee,1 sarah a. D for yolk sac tumor, and answer e is often seen in anaplastic large cell lymphoma. Anaplastic thyroid cancer american thyroid association.
Few previous series have analyzed these tumors separately from the more common. The type of cancer depends on which type of cell it started in. The information in this brochure pertains to anaplastic thyroid cancer. Anaplastic variant of classical seminoma of the testis. Germ cell markers oct 34, cd117 are useful in the diagnosis. The clinical presentation of young and middleaged men with metastatic disease with an unknown primary site is a common problem for general histopathologists. Media in category histopathology of testicular seminoma the following 49 files are in this category, out of 49 total. Analytical and quantitative cytopathology and histopathology. Anaplastic thyroid cancer is very rare and is found in less than 2% of patients with thyroid cancer. Rare variants of the classic seminoma include anaplastic seminoma 5 to 10% and spermatocytic seminoma 4 to 6%. It shows a wide spectrum of morphological presentations and the diagnosis could be challenging due to its high degree of dedifferentiation. Webpathology is a free educational resource with 10350 high quality pathology images of benign and malignant neoplasms and related entities. Staging procedures included meticulous physical and neurological examinations, complete blood count, full biochemistry profile, specific tumor markers, testicular ultrasound, and other radiological measures. Bep x 3 cycles or ep x 4 cycles for patients with good prognosis bep x 4 cycles for patients with intermediate prognosis 31.
Spermatocytic seminoma is an uncommon neoplasm unique to the testis with clinicopathologic features distinctive from classic seminoma, and is not considered a variant of the latter. Tumors of the lymphoreticular system, including spleen and thymus. Testicular malignancies 2015 1815 naaccr 20142015 webinar series 6 mature teratoma icd o 3 histology for mature teratoma is 90800. Anaplastic seminoma definition of anaplastic seminoma by. Adetailed description ofthe histopathology ineach ofthese subgroups istobepublished. Two patients with stage i disease and one patient with stage iv disease have died from. Treatment of lowstage anaplastic large cell lymphoma study inclusion criteria n treatment description efs os comments nhlbfm90 1990199522 stage i or ii completely resected seminoma with trophocarcinoma friedman and pearlman 47 table 1. Pure seminoma is a rare pathology of the young adult, often discovered in the early stages. Anaplastic thyroid cancer is the most advanced and aggressive thyroid cancer. Pure seminoma slow growth and dissemination, very high radiocurability. Seminoma definitionpage contents1 seminoma definition2 seminoma icd9 code3 seminoma epidemiology4 seminoma types5 seminoma.
Anaplastic skeletal muscle cells make little actin and myosin lose cross striations anaplastic colonic epithelial cells make little or no mucin anaplastic glandular cells make only few glands. Anaplastic seminoma of the testis ultrastructural analysis of three cases mark janssen, md and william h. Anaplastic seminoma cells are more pleomorphic and the stroma has fewer lymphocytes. Anaplastic large cell lymphoma, also called ki1 lymphoma, is a morphologically and immunologically distinct subset of nonhodgkins lymphoma originally.
Seminoma, anaplastic 906234 malignant teratoma, undifferentiated 908234 malignant teratoma, intermediate type 908332 intraosseous osteosarcoma, well differentiated 918731 astrocytoma, anaplastic 9404 oligodendroglioma, anaplastic 9454 retinoblastoma, differentiated 9511 retinoblastoma, undifferentiated 951234 4. Anaplastic seminoma is diagnosed when there are three or more mitoses seen per highpower field. Typically a well demarcated, uniform neoplasm with characteristic cytological features and background of fibrous septae and lymphocytes. Seminoma accounts for 50% of all testicular germinal cell tumors. Anaplastic variant of spermatocytic seminoma sciencedirect. Anaplastic large cell lymphoma accounts for less than 10% cases of all lymphomas. Toxicity issues and the patients preferences should be. The recognition of anaplastic seminoma with a possible worse prognosis remains. Atlas of tumor pathology, armed forces institute of pathology, washington. Anaplastic seminoma clinically, this behaves like pure seminoma but with a slightly greater propensity for metastasis and slightly worse. The pt category was correlated neither with clinical substage nor relapse rate.
Diagnostic pitfalls in the histopathological diagnosis of testicular germ cell tumours jeffrey m. Welcome to the updated version of pathology for urologists. If the diagnostic term in the pathology report is not in the list below, be sure to consult your icdo3 manual 60% of testicular cancers will show a single cell type. Seminoma, nos 90623 seminoma, anaplastic 90633 spermatocytic seminoma c384 pleura c390,c398c399 respiratory, nos 936 peripheral neuroectodermal tumor 93643. Risk factors, their interrelationship, and prognostic relevance for seminoma stage ii disease have been examined. Yolk sac tumor non seminoma is the more cl inically aggressive tumor.
However, the tumor cells showed prominent nucleoli. An overview of testicular germ cell tumors archives of pathology. Testicular and paratesticular tumors study questions. Seminoma either alone or in combination with other tumour elements is found in about one half of testicular tumours. Anaplastic thyroid carcinoma atc is the most aggressive form of thyroid cancer.
Seminoma and embryonal carcinoma are closely related entities. Radiation oncologytestisseminoma wikibooks, open books. Sep 05, 2019 anaplastic seminoma is observed in 5%15% of patients with seminomas. This benign glandular tumor adenoma is projecting into the colonic lumen and is attached to the mucosa by a distinct stalk.
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