Morphological approach to tumours of the testis and paratestis

Emerson, Robert E.; Ulbright, Thomas M.

doi:10.1136/jcp.2005.036475

Cited by 65 publications

(56 citation statements)

References 99 publications

(64 reference statements)

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“…The sarcomatoid region had random fascicular and storiform arrangements with necrotic or hemorrhagic foci, and exhibited high mitotic activity, nuclear atypia, and local invasion of the capsules, as previously described for human Leydig cell tumors with spindle-shaped cells [17]. The immunohistochemical features of the tumor in our case were partly similar to those of Leydig cell tumors with spindleshaped cells, which are also positive for inhibin, S-100, and vimentin [3]. However, human Leydig cell tumors with spindle-shaped cells are generally negative for aSMA [17].…”

supporting

confidence: 58%

Malignant Leydig Cell Tumor with Spindle-Shaped Cells in a Male CD-1 Mouse

Ohnuma

Yoshida

Takahashi

et al. 2010

The Journal of Veterinary Medical Science

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ABSTRACT. Leydig cell tumors with spindle-shaped cells are very rare in humans and animals. We report that an 84-week-old male CD-1 mouse had a malignant Leydig cell tumor characterized by proliferation of oval to spindle-shaped cells with or without fat deposition, and with a storiform pattern. These cells were immunopositive for inhibin and S-100, and negative for the androgen receptor, thereby suggesting that they may have differentiated from Leydig cells. This differentiation from Leydig cells was further confirmed by the immunopositivity of these cells for nestin and -smooth muscle actin, both of which are known to be expressed in the stem/progenitor cells that differentiate into Leydig cells. These findings suggest that the tumor is most probably a malignant spindle-cell-type Leydig cell tumor.

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supporting

confidence: 58%

Malignant Leydig Cell Tumor with Spindle-Shaped Cells in a Male CD-1 Mouse

Ohnuma

Yoshida

Takahashi

et al. 2010

The Journal of Veterinary Medical Science

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“…Similarly, benign and malignant mesothelial proliferations, including adenomatoid tumor, mesothelial hyperplasia, and mesothelioma, can occur in the testis/ paratestis. [30][31][32][33][34] All of these entities express calretinin and WT-1, 32-34 similar to the immunophenotype of TV. SC tumors of the testis frequently express WT1 and calretinin, which according to our study is a close recapitulation of the fetal normal SC phenotype instead of the adult normal SC phenotype, thus proposing the hypothesis that these tumors acquire a dedifferentiated phenotype resembling SC seen in primitive/fetal sex cords.…”

Section: Discussionmentioning

confidence: 87%

“…Mu¨llerian-type epithelial neoplasms rarely occur in the testis and the paratestis and reportedly express CK7, ER, and PR, 33,35,36 although the full immunophenotype has not been extensively studied. According to the results of our study, this IHC marker pattern demonstrates similarities to adult DE, TA, and EA; it would be interesting to examine PAX8, WT1, and other pertinent markers in these tumors, which may shed light on the histogenesis of these rare testicular/paratesticular tumors.…”

Section: Discussionmentioning

confidence: 98%

Comprehensive Immunophenotypic Characterization of Adult and Fetal Testes, the Excretory Duct System, and Testicular and Epididymal Appendages

Magers¹,

Udager²,

Chinnaiyan

et al. 2016

Applied Immunohistochemistry &Amp; Molecular Morphology

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The immunophenotype of a normal testis and the excretory duct system has not been studied comprehensively in fetal and adult patients without testicular disease or hormonal manipulation so far. In addition, testicular (TA) and epididymal (EA) appendages are frequent paratesticular structures without previously reported comprehensive immunophenotypic studies. Immunohistochemistry for multiple markers, including the androgen receptor (AR), the estrogen receptor (ER), the progesterone receptor (PR), the prostate-specific antigen, the prostate-specific membrane antigen, PAX8, WT1, calretinin, CK7, CK20, OCT4, SALL4, and CD117, was performed on full sections of testicular/paratesticular tissue from a large cohort of adult and fetal autopsy patients. In contrast to adult germ cells (GC), fetal GC strongly express OCT4 and CD117, although the expression of these proteins is lost in the early postnatal period; SALL4, in contrast, is expressed in both fetal and adult GC, with only weak and focal expression in adult patients. Fetal Sertoli cells (SC) express WT1 and calretinin strongly and diffusely, in contrast to adult SC. Both fetal and adult excretory duct systems express CK7 and PAX8 with frequent AR coexpression, and all 3 main segments of the excretory duct system (ductuli efferentes, epididymis, and vas deferens) have unique immunophenotypes. The rete testis also has a unique immunohistochemical expression pattern, which includes strong expression of CK7, PAX8, WT1, calretinin, and AR. Finally, of the adult autopsy patients examined, 80% had a TA, and 60% had an EA; these paratesticular structures occurred at stereotypical locations, demonstrated reproducible morphologic features, and had a unique immunophenotype relative to other studied structures, with strong CK7, PAX8, WT1, AR, ER, and PR coexpression. The testis and the paratestis may be involved by diverse neoplastic and non-neoplastic processes, and knowledge of the immunophenotypic expression spectrum of these tissues may aid in clinical diagnosis and advance our understanding of the pathogenesis of both oncologic and nononcologic disease processes.

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“…Paratesticular are rare neoplasms that can arise from the epididymis, mesenchymal layers surrounding the testis and its true appendages or spermatic cord. It is often difficult, however, to localize the precise origin of these tumors [14] ( fig. 1 ).…”

Section: Discussionmentioning

confidence: 99%

Paratesticular Sarcomas in Brazil

Korkes¹,

Castro²,

Romero³

et al. 2009

Urol Int

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Purpose: Paratesticular sarcomas are rare and frequently reported as isolated case reports. Studies evaluating the relative frequency of the paratesticular sarcomas are limited, and to the best of our knowledge, this is the first study of paratesticular sarcomas in the Brazilian population. Patients and Methods: Medical records of all patients undergoing treatment for paratesticular sarcomas between 1993 and 2006 were retrieved from the archives of our institution. Results: Complete data from 12 patients (39 ± 23 years, range 13–78) with paratesticular sarcomas were available, which represented 6.7% of all orchiectomies performed for testicular malignancies in the same period. At the time of diagnosis, 3 patients had retroperitoneal spread of the disease, all of which had elevated serum lactic dehydrogenase levels. The remaining 9 patients had normal serum markers. There were 6 rhabdomyosarcomas, 4 leiomyosarcomas, 1 liposarcoma and 1 undifferentiated sarcoma. Median follow-up was 31.4 months. Primary surgical excision by inguinal approach was performed in all cases (radical orchiectomy in 10 and preservation of the testis in 2). Retroperitoneal lymph node dissection was performed in 3 patients and excision of the hemiscrotum in 1. Eight patients received adjuvant chemotherapy. Mean overall survival time was 27.8 ± 6.2 months after orchiectomy. Conclusion: Patients with paratesticular sarcomas are at high risk of disease progression, and systemic relapse remains a significant problem, determining poor prognosis. The high risk of local recurrence demands long-term follow-up, and intraoperative frozen section analysis might be of benefit. Elevated lactic dehydrogenase might also be a marker of retroperitoneal disease and poor prognosis. Improvement in survival requires effective systemic adjuvant therapy.

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Morphological approach to tumours of the testis and paratestis

Cited by 65 publications

References 99 publications

Malignant Leydig Cell Tumor with Spindle-Shaped Cells in a Male CD-1 Mouse

Malignant Leydig Cell Tumor with Spindle-Shaped Cells in a Male CD-1 Mouse

Comprehensive Immunophenotypic Characterization of Adult and Fetal Testes, the Excretory Duct System, and Testicular and Epididymal Appendages

Paratesticular Sarcomas in Brazil

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