Germ cell tumor pathophysiology: Difference between revisions

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(Pathophysiology)
(Pathophysiology)
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* Th [[ovaries]] and [[testes]] are called [[gonads]] and many [[ovarian]] and [[testicular]] [[tumors]] have [[germ cell]] origin.
* Th [[ovaries]] and [[testes]] are called [[gonads]] and many [[ovarian]] and [[testicular]] [[tumors]] have [[germ cell]] origin.
*The [[pathophysiology]] of [[germ cell tumors]] is different based on the [[classification]] of [[germ cell tumors]]
*The [[pathophysiology]] of [[germ cell tumors]] is different based on the [[classification]] of [[germ cell tumors]]
*Each of the distinct entities of germ cell tumor has a different pathogenesis
*Each of the distinct entities of [[germ cell tumor]] has a different [[pathogenesis]]
*Germ cell tumors are classified as;
*[[Germ cell tumors]] are [[classified]] as;
** Gonadal
**[[Gonadal]]
*** Seminoma
***[[Seminoma]]
*** Dysgerminoma
***[[Dysgerminoma]]
***Germinoma
***[[Germinoma]]
** Extragonadal
** Extragonadal
***Embryonic
***[[Embryonic]]
**** Mature/Immature teratoma
**** Mature/Immature teratoma
*** Extraembryonic
*** Extraembryonic
**** Chorio carcinoma/Yolk sac tumor <br />
**** Chorionic carcinoma/Yolk sac tumor <br />


== '''Testicular Seminoma''' ==
== '''Testicular Seminoma''' ==

Revision as of 20:43, 6 August 2019

Testicular Seminoma

  • Accounts for about a third of all testicular germ cell malignancies and is one of the most treatable cancers with a survival rate of 98% to 99% in early-stage disease
  • originates in the germinal epithelium of the seminiferous tubules as a result from the proliferation of immature spermatogonia   
  • On gross pathology, seminoma is characterized by pale gray to yellow nodules that are uniform or slightly lobulated and often bulge from the cut surface.
  • Microscopic Pathology:
    • On microscopic pathology, seminoma is characterized by
    • Cells with fried egg appearance - key feature
    • Clear cytoplasm
    • Central nucleus, with prominent nucleolus. Nucleus may have "corners", i.e. it is not round.
    • Large, irregular, vesicular nuclei
    • Eosinophilic vacuolated cytoplasm (contains hCG)
    • Florid granulomatous reaction
    • Approximately 24% of Stage I seminomas have lymphovascular invasion for stage I (Tx, N0, M0).
    • Intertubular seminoma may not form a discrete mass and mimic a benign testis.


Dysgerminoma

The pathophysiology of ovarian germ cell tumors depends on the histological subtype. Their common origin is believed to be from the primordial germ cells that transformed pathologically in different stages of development. It is difficult to distinguish subtypes of ovarian germ cell tumor on gross pathology alone. The majority of ovarian germ cell tumors have a solid and cysticappearance with areas of hemorrhage and necrosis. On microscopic pathology, ovarian germ cell tumors may be characterized by a uniform “fried egg” appearance (dysgerminoma), presence of Schiller-Duval bodies (yolk sac tumor), presence of embryonic-like neural, gastrointestinal, and/or cartilaginous tissue (teratoma), or mixed histopathological features (embryonal cell carcinoma).

Germinoma

On microscopic histopathological analysis, uniform cells that resemble primordial germ cells, consisting of large, round cells with vesicular nuclei and clear or finely granular cytoplasm that is eosinophilic are characteristic findings of germinoma. Genes involved in the pathogenesis of germinoma include gains of 1p, 8p, and 12q and losses of 13q and 18q, duplication of the short arm of chromosome 12, loss of 1p and 6q, alterations in sex chromosomes in children, alterations of the p14 gene, mutations of the c-kit gene, aberrations of CCND2 (12P13), and RB1, and gain-of-function mutations of KIT. The progression to germinoma usually involves the mutations of the KIT/RAS signalling or AKT1/mtor pathways and cyclin/CDK-RB-E2F pathway if CCND2(12P13) and RB1 genes are aberrated

Infantile testis teratomas

Yolk sac tumors

References