Germ cell tumors

dermoid cyst

Type of mature teratoma with differentiation toward Ectodermal! Macro: cyst filled with Sebum&Hair Micro: Cyst lined by differentiated epidermis with skin appandages

cryptorchism

failure of one or both testes to descend into the scrotum: Risk factor for germ cell tumors

Yalk sac tumor

-Malignant,aggressive -differentiation towards embryonal yalk sac -in pure form:small childrens-the most common germ cell in babies! -as component of mixed tumor-in young adult -usually diagnosis due to increase serum Alpha fetoprotein Micro:sometimes form structure similar to primitive glomerulus:called Schiller Duval bodies

Spermatocytic seminoma

-Not related to classical seminoma -have 3 types of cells: 1)small round completely immature cells-resemble lymphocytes 2)Medium size cells with round nuclei-resemble spermatocytes 3)Large cells with 1 or multiple nuclei

Metastatic spread from testis

-Regional lymph node-Lumbar -Distant organs-specialy Lungs!!! -Seminomas disseminate to lymph nodes,organ in later phase -Non seminomaa tumor,specialy choriocarcinoma-Disseminate very early to organs!

Immunohistochemistry (IHC) of Germinal tumors

-Seminomas-PLAP: Placental alaklic phosphatase -Embryonal carcinoma-CD 30 -Yalk sac tumor: Alpha fetoprotein -Choriocarcinoma-hCG

Mature-differentiated teratom

-all tissue wich found in the teratoma differentiated!!! -usually neuroectodermal tissue-skin,glial tissue,ependyma,choroid olexus but can be also cartilage,bone Its benign!!!

Embryonal carcinoma

-completely Non differentiated carcinoma:we even dont know if its somatic/extrasomatic -in young adult -Malignant-aggressive -can be Pure or as component of mixed germ cell tumor Macro: Large regions of necrosis&Hemorrhage (not in seminoma) Micro: Large polygonal cells with eosinophilc cytoplasm+large nuclei&nucleoli+ mitosis

Mixed grem cell tumor

-have more than 1 germ cell tumor -the most common combination: *Choriocarcinoma+teratoma *Yalk sac tumor+teratoma

choriocarcinoma

-malignant,aggressive -differentiation towards trophoblast: Syncitio/cytotropho/intermediate -in young adult -usually as part of mixed germ cell tumor (pure form is rare) -Have Early metastasis,specialy to lungs! Macro:small,with extensive hemorrhage&necrosis Micro: Extreme Atypia and pleomorphism

Gonadoblastoma

-mixed germ cell+gonadostromal ovarian tumor -almst always associated witt gonadal dysgenesis: Any congenital disorder of development of reproductive system. Histologicaly: mixture of primitive germinal&Gonadostromal cells. Its a Benign tumor,but can be lrecursor to malignant germ cell tumor.

Seminoma/non seminoma

-seminoma: Tumor from neoplastic germ cells with suppressed differentiation. The tumor stays on the level of Gonocytes! -Non seminoma: Have ability to differentiate toward somatic and extrasomatic tissue. Can be fully differentiate-Mature teratoma or partialy-immature teratoma/embryonal carcinoma/yalk sac tumor/choriocarcinoma

Immature teratoma

-some tissue are not fully differentiated -usually non mature neural tissue-resemble primitive neural tube. -Malignant!!! Macro: Cystic+solid areas

Polyembryoma

-special subtype of mixed germ cell tumor,very rare! -contains embryonal bodies:resemble early embryo

Group of testicular tumors

1)germ cell tumor-the most common!!! 2)Gonadostromal tumors-from Lyiding+Sertoli cells 3)Lymphomas-most common in old 4)tumor of paratesticular structures 5)secondary tumor-metastasis

Teratoma of testis

1)pre-pubertal teratoma: In babies,usually benign,immature 2)post-pubertal teratoma: All of them harbor risk to sever oncogenic mutation! Have malignant potential

Groups of ovaries tumors

1)tumor from superficial: Mullerian epithelium- The most common group 2)germ cell tumor 3)gonadostromal tumors The most common germ cell tumor in ovaries:Teratoma!

Teratoma

Can be found in various location in body,typical in sacral region

Difference between seminoma-spermatocytic tumor

Clasical seminoma: spermatocytic: 1 type cells 3 type cells Arise from intratubular no In younger adult in old people Usually in testis Only in testis Good prognosis aggressive

Seminomas

Classical seminoma: -in younger adult If we see seminoka in childrens: Consider mixed germ cell tumor! -Malignant tumor,good prognosis! -the Most common Testicular germ cell -in Ovaries:caled DYSgerminoma -can be intracanalicular growth-growth in lumen of tubules. -the testicles are not enlarge Macro: Solid,homogenous,gray Micro: Pale cytoplasm,full of GLYCOGEN! Predominant nucleoli-resemble primitive gonocytes -chronic inflammation of interstitium,sometimes granuloma!!! Sometimes trophoblast can be present Sometimes sever Atypia-Anaplastic seminoma

Gestational choriocarcinoma

In association to pregnancy! Usually molar pregnancy. Or it can be not related to pregnancy: Non gestationla choriocarcinoma: Have worse prognosis

Germ cell neoplasia in situ

Intratubular Germinal cell neoplasia-ITGCN -represent IN SITU germ cell tumor -common precursor lesion of testicular grem cell tumr -Atypical large polygonal cells in seminefreous tubules

Stroma Ovarii (ovarian goiter)

Mature teratoma,formed by Thyroid gland tissue. Ovary is typical location:can be Ectopic source of hyperthyroidism

Germ cell tumors

Usually in testis&ovaries,but can be everywhere! -Arising from Multipotent stem cells Wich can differentiate to somatic tissue or extrasomatic tissue-trophoblast/yalk sac. The tumor can be differentiate toward: 1)Gonocyted-seminoma&Dysgerminoma 2)somatic tissue- Embryonal carcinoma,teratoma 3)Extrasomatic tissues- Yalk sac tumor,choriocarcinoma

testicular tumors prognosis

-Seminomas: Usually good -non seminomas: Worse prognosis