Fine‐needle aspiration cytology of an endometrioid‐like variant of yolk sac tumor

Abstract

A 36-year-old male with a history of immature teratoma and embryonal carcinoma of the testis was admitted to the hospital for abdominal pain and fever. A CT scan revealed a large right abdominal mass. The patient's serum alpha-fetoprotein (AFP) was 46.8 ng/ml (reference < 25 ng/ml). Fine-needle aspiration (FNA) of the mass revealed malignant glandular cells. Chemotherapy was instituted, followed by resection of the large abdominal mass. The tumor was grossly encapsulated, consisting of large areas of necrotic, hemorrhagic tissue surrounded by smaller, multiloculated cysts. Microscopically, the tumor had a villoglandular pattern and variably stratified tall columnar cells. A prominent feature of the columnar cells was supranuclear and subnuclear vacuolization. Intracytoplasmic PAS-positive, diastase-resistant hyaline globules were occasionally present. AFP by immunoperoxidase was prominent within the tumor. This recurrence of the previously diagnosed testicular teratoma with embryonal carcinoma represents a yolk sac tumor with components strongly resembling endometrioid carcinoma, a variant only recently described in eight cases of ovarian origin (Clement et al.: Am J Surg Pathol 1987; 11(10):767-778). We believe this is the first reported case of an endometrioid-like variant of testicular yolk sac tumor and also the first report of the FNA cytology findings in this variant.

Fine‐needle aspiration cytology of seminoma: A review of 16 cases

“…Endoder-ma1 sinus tumor also has a markedly vacuolated cytoplasm that may contain homogeneous hyalin inclusions. 3, 14,15 Immunocytochemical studies may be helpful in establishing the correct diagnosis. Both embryonal carcinoma and endodermal sinus tumor show positive staining for AFP and keratin.…”

“…Serum human chorionic gonadotrophin (hCG) and its &subunit was elevated in eight cases (Nos. 2, 4, 5, 6, 8,11,13,15). There were 13 gonadal seminomas (including one occurring in a cryptorchid testis) and three extragonadal tumors originating in the mediastinum.…”

Is it feasible to diagnose germ-cell tumors by fine-needle aspiration biopsy?

“…[1][2][3] Several studies have reported the various cytologic features which are seen in aspiration smears from yolk-sac carcinoma. 4,5,11,[20][21][22][23][24] However, the precise cytologic appearances corresponding to the various histologic patterns of yolk-sac carcinoma are not fully understood, so that prediction of the exact morphologic pattern in aspiration smears may not always be possible. However, it is helpful to recognize that in cytologic smears these patterns may be represented by an interplay of two types of tumor cells.…”

Fine-Needle Aspiration Biopsy (FNAB) Diagnosis of Germ Cell Tumors: Histologic and Cytologic Correlations

“…Fine-needle aspiration biopsy findings in yolk sac tumors have been described in several studies. [2][3][4][5][22][23][24][25][26][27] The aspiration smears are moderately cellular, and contain tightly arranged clusters of epithelial cells with relatively abundant cytoplasm. These cells may be arranged as solid sheets, papillary or glandular structures, or as small globular structures (tumor balls) ( Figure 9).…”