Abstract
BackgroundMalignant germ cell tumours are the most common malignant tumours in young men. They are histologically divided into seminomas and non-seminomas. Non-seminomas are further subdivided into embryonic carcinomas, yolk sac tumours, chorionic carcinomas, and teratomas. For the therapeutic management it is essential to differentiate between these histological subtypes.MethodsInvestigated cases included normal testis (n = 50), intratubular germ cell neoplasia (n = 25), seminomas (n = 67), embryonic carcinomas (n = 56), yolk sac tumours (n = 29), chorionic carcinomas (n = 2), teratomas (n = 7) and four metastases of YST’s for their CK19 expression. In addition Leydig cell- (n = 10) and Sertoli cell- tumours (n = 4) were included in this study.ResultsAll investigated seminomas, embryonic carcinomas as well as normal testis and intratubular germ cell neoplasias did not express CK19. In contrast, all investigated yolk sac tumours strongly expressed CK19 protein. These findings became also evident in mixed germ cell tumours consisting of embryonic carcinomas and yolk sac tumours, although CK19-expression could also be observed in analysed chorionic carcinomas and epithelial components of teratomas.ConclusionCK19 proved to be a sensitive marker to identify yolk sac tumours of the testis and to distinguish them from other germ cell tumours, especially seminomas and embryonic carcinomas.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4075546891400979.
Highlights
Malignant germ cell tumours are the most common malignant tumours in young men
Non-seminomas are further subdivided into embryonic carcinomas (EC), yolk sac tumours (YST), chorionic carcinomas (CC), and teratomas (TER) [3]
CK19 expression was evident in the different growth patterns of YST such as reticular/microcystic pattern (Figure 2A and B), solid pattern (Figure 2C and D), papillary pattern (Figure 2E and F) or endodermal sinus pattern with festooned appearance (Figure 2G and H)
Summary
Malignant germ cell tumours are the most common malignant tumours in young men. They are histologically divided into seminomas and non-seminomas. Non-seminomas are further subdivided into embryonic carcinomas, yolk sac tumours, chorionic carcinomas, and teratomas. For the therapeutic management it is essential to differentiate between these histological subtypes. Testicular germ cell tumours (TGCTs) are the most common malignancies in young men at the age of 15 to 40 years [1]. TGCTs are histologically and clinically grouped into seminomas (SEM) and non-seminomas. Non-seminomas are further subdivided into embryonic carcinomas (EC), yolk sac tumours (YST), chorionic carcinomas (CC), and teratomas (TER) [3]. The distinction between the different histological tumour types is important for the therapeutic management.
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