Neoplasms of the testis

Ulbright, Thomas M.; Emerson, Robert E.

doi:10.1016/b978-0-323-01970-5.50015-4

Cited by 11 publications

(31 citation statements)

References 693 publications

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“…31,33,37 An association between asbestos exposure and mesotheliomas of the tunica has been previously described, with some studies reporting an association in up to 50% of cases. As with pleural mesotheliomas, the latent period may be long, up to 20 years in some cases.…”

Section: Discussionmentioning

confidence: 90%

The Immunohistochemical Profile of Malignant Mesotheliomas of the Tunica Vaginalis

Winstanley¹,

Landon²,

Berney³

et al. 2006

The American Journal of Surgical Pathology

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Malignant mesotheliomas of the testis arise from the tunica vaginalis, formed from the evagination of the abdominal peritoneum into the scrotum. The immunohistochemical profile of the tunica vaginalis and associated neoplasms is often extrapolated from thoracic studies. Testicular series are uncommon, usually derived from previous case studies and literature reviews. The immunohistochemical findings in 20 cases originally diagnosed as malignant mesotheliomas are presented. Archival testicular malignant mesothelioma specimens from 1959 to 2004 were collected from hospitals throughout the United Kingdom and from the authors' own archives. Hematoxylin and eosin-stained sections were reviewed, and selected sections from each case were then examined using an immunohistochemical panel of eight antibodies: calretinin (Zymed, 1:200), epithelial membrane antigen (EMA) (DAKO, 1:50), thrombomodulin (DAKO 1:5), CK7 (DAKO, 1:100), CK5-CK6 (DAKO, 1:10), BerEp4 (DAKO, 1:25), carcinoembryonic antigen (CEA) (DAKO, 1:10), and CK20 (DAKO, 1:100). The EnVision technique was used for all antibodies. Sections were reviewed independently by three pathologists. Electron microscopy was performed on selected cases. In all cases, the morphologic light microscopy criteria for a diagnosis of malignant mesothelioma were present. However, two tumors were later excluded from the study because of diffuse strong positive immunostaining with CK20 and BerEp4 and an ultrastructural appearance of adenocarcinoma. Of the remaining cases, 15 of 18 (83%) were purely epithelioid in type, showing a mixture of papillary, tubular, and solid patterns, and 3 of 18 (17%) showed a mixed sarcomatoid/epithelioid pattern. All cases were positive for calretinin and EMA (100%), 16 of 18 (89%) were positive for thrombomodulin, and 15 of 18 (83%) were positive for CK7. CK5-CK6 positivity was present in 13 of 18 (72%) but varied in strength and distribution; 2 of 18 (11%) were positive for BerEp4. All the cases were negative for CK20 and CEA. Four of the 18 cases were examined by electron microscopy, which revealed long thin microvilli supporting a diagnosis of malignant mesothelioma. This study has shown that the immunocytochemical profile of testicular malignant mesotheliomas is similar to those arising in the pleura, with diffuse positivity for calretinin, EMA, thrombomodulin, and CK7, and negative for CK20 and CEA. Focal weak positivity may be encountered with BerEp4. However, histopathologists should be aware of the variability in CK5-6 staining in testicular specimens when compared with pleural mesotheliomas.

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Section: Discussionmentioning

confidence: 90%

The Immunohistochemical Profile of Malignant Mesotheliomas of the Tunica Vaginalis

Winstanley¹,

Landon²,

Berney³

et al. 2006

The American Journal of Surgical Pathology

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“…Multifocality, the combination with solid areas, and atypia must raise the suspicion of a potentially malignant tumor. Actually, even some apparently benign lesions have evolved towards a more aggressive course [28,38,50,53].…”

Section: Benign Mesotheliomamentioning

confidence: 99%

“…The cystic cases must be distinguished from hydrocele in the testis or from cystic lymphangiomas in both the testis and the peritoneal cavity [15,38,47,[50][51][52]. There is question regarding their true neoplastic nature.…”

Section: Benign Mesotheliomamentioning

confidence: 99%

“…Malignant Mesothelioma is defined as a proliferation of mesothelial cells with malignant morphological features and aggressive growth, arising in the peritoneal cavity, or in the tunica vaginalis and the tunica albuginea [28,38,[50][51][52][53]. Patients with mesothelioma originating in one of these two sites may subsequently develop a tumor in the other.…”

Section: Malignant Mesotheliomamentioning

confidence: 99%

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Extrathoracic Mesothelial Proliferations and Their Mimics

Lloreta‐Trull

2006

Ultrastructural Pathology

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Mesothelial proliferations, either reactive or neoplastic in nature, often pose difficult diagnostic dilemmas. Electron microscopy continues to be a gold standard in the identification of mesothelial differentiation. However, it is very common to apply long panels of antibodies for that purpose. In most cases, light microscopy and immunohistochemistry will solve the problem. However, the definitive, specific, and sensitive immunohistochemical marker is still lacking. This is particularly true in peritoneal and testicular mesothelial tumors, in which common embryologic origin with epithelial elements results in overlapping immunohistochemistry and morphology. The particularities of peritoneal and testicular mesothelial proliferations, and the main tumors that may mimic them in these sites, as well as the value and limitations of immunohistochemistry and electron microscopy in their differential diagnosis are the subject of this review.

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“…Testicular LCT can occur at any age, 20% occur in prepubertal boys between 5 and 10 years of age and 80% occur in men aged 30 to 60 years. 2,3 LCT is hormonally active and is a steroid-secreting tumor resulting in either virilizing or feminizing syndromes. 4 There are no known risk factors for this tumor in the human male.…”

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confidence: 99%

Testicular leydig cell tumor diagnosed on fine needle aspiration

Handa

Sood

Punia

2010

Diagnostic Cytopathology

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We report on the cytopathologic findings of a Leydig cell tumor of the testis in an adult male with no evidence of endocrine dysfunction. The preoperative diagnosis was based on fine needle aspiration cytology (FNAC) and was subsequently confirmed on histomorphology. The cytologic smears were cellular and showed tumor cells arranged singly, as well as in dyscohesive clusters. The tumor cells were large, round to polygonal, with indistinct cytoplasmic margins and pale, abundant, granular to vacuolated cytoplasm. A few intranuclear Reinke's crystals that are considered pathognomonic and essential for the diagnosis were seen. The present case was of interest because of the scarcity of literature on the cytodiagnosis of this tumor. The use of FNAC for diagnosis may vitiate the need for more invasive biopsy procedures in the preoperative diagnosis of this rare testicular tumor.

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Neoplasms of the testis

Cited by 11 publications

References 693 publications

The Immunohistochemical Profile of Malignant Mesotheliomas of the Tunica Vaginalis

The Immunohistochemical Profile of Malignant Mesotheliomas of the Tunica Vaginalis

Extrathoracic Mesothelial Proliferations and Their Mimics

Testicular leydig cell tumor diagnosed on fine needle aspiration

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