Spermatocytic Seminoma

A Report of 85 Cases Emphasizing its Morphologic Spectrum Including Some Aspects not Widely Known

Rong Hu, Thomas Ulbright, Robert H. Young

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Spermatocytic seminoma (or, alternatively, spermatocytic tumor) of the testis is rare and errors in pathologic diagnosis are still made. As it has a good prognosis, except when it, rarely, undergoes sarcomatous transformation, accurate diagnosis and differentiating it from usual seminoma and other malignant neoplasms such as lymphoma are crucial. To potentially contribute information of diagnostic aid we reviewed the largest series of cases reported to date to characterize in detail their histologic spectrum. The patients ranged from 30 to 81 years (average, 52 y); 30% were in the fourth decade. The neoplasms ranged from 1.4 to 15 cm (average, 5.7 cm). Most were fleshy, soft, and often lobulated and 11 were edematous or mucoid. Low-power microscopic examination either showed a predominant multinodular (43/85) or diffuse (42/85) pattern. All tumors had the classic “tripartite” cellular population. Five tumors showed a relatively monomorphic population of the intermediate cell type with vesicular chromatin and very prominent nucleoli, at least focally. Two tumors underwent sarcomatous transformation, with 1 having a focus of atypical cartilage. Additional findings, some not previously reported or emphasized, included: (1) frequent edema fluid (87%) often causing spaces, both follicle-like (24%) and irregular (39%), a finding seen in some usual seminomas (but less frequently) and rarely seen in lymphomas; (2) tumor nodules showing partial rims of fibrin (20%); (3) a distinctive arrangement of connecting tumor islands (19%); (4) prominent lymphocytic infiltrates (8%); (5) granulomatous inflammation (1%); (6) striking mitotic activity and apoptosis; (7) intratubular spread (64%); and (8) vessel invasion (11%) and necrosis (8%). Awareness of these aspects may be of importance either at the time of intraoperative evaluation or on final pathologic analysis and help avoid significant errors in diagnosis.

Original languageEnglish (US)
JournalAmerican Journal of Surgical Pathology
DOIs
StateAccepted/In press - Dec 26 2017

Fingerprint

Seminoma
Neoplasms
Lymphoma
Fibrin
Islands
Population
Chromatin
Cartilage
Testis
Edema
Necrosis
Apoptosis
Inflammation

Keywords

  • germ cell tumor
  • spermatocytic seminoma
  • spermatocytic tumor
  • testicular neoplasms
  • testis

ASJC Scopus subject areas

  • Anatomy
  • Surgery
  • Pathology and Forensic Medicine

Cite this

@article{e6f480a8e3f04fee854d2f80e8783afb,
title = "Spermatocytic Seminoma: A Report of 85 Cases Emphasizing its Morphologic Spectrum Including Some Aspects not Widely Known",
abstract = "Spermatocytic seminoma (or, alternatively, spermatocytic tumor) of the testis is rare and errors in pathologic diagnosis are still made. As it has a good prognosis, except when it, rarely, undergoes sarcomatous transformation, accurate diagnosis and differentiating it from usual seminoma and other malignant neoplasms such as lymphoma are crucial. To potentially contribute information of diagnostic aid we reviewed the largest series of cases reported to date to characterize in detail their histologic spectrum. The patients ranged from 30 to 81 years (average, 52 y); 30{\%} were in the fourth decade. The neoplasms ranged from 1.4 to 15 cm (average, 5.7 cm). Most were fleshy, soft, and often lobulated and 11 were edematous or mucoid. Low-power microscopic examination either showed a predominant multinodular (43/85) or diffuse (42/85) pattern. All tumors had the classic “tripartite” cellular population. Five tumors showed a relatively monomorphic population of the intermediate cell type with vesicular chromatin and very prominent nucleoli, at least focally. Two tumors underwent sarcomatous transformation, with 1 having a focus of atypical cartilage. Additional findings, some not previously reported or emphasized, included: (1) frequent edema fluid (87{\%}) often causing spaces, both follicle-like (24{\%}) and irregular (39{\%}), a finding seen in some usual seminomas (but less frequently) and rarely seen in lymphomas; (2) tumor nodules showing partial rims of fibrin (20{\%}); (3) a distinctive arrangement of connecting tumor islands (19{\%}); (4) prominent lymphocytic infiltrates (8{\%}); (5) granulomatous inflammation (1{\%}); (6) striking mitotic activity and apoptosis; (7) intratubular spread (64{\%}); and (8) vessel invasion (11{\%}) and necrosis (8{\%}). Awareness of these aspects may be of importance either at the time of intraoperative evaluation or on final pathologic analysis and help avoid significant errors in diagnosis.",
keywords = "germ cell tumor, spermatocytic seminoma, spermatocytic tumor, testicular neoplasms, testis",
author = "Rong Hu and Thomas Ulbright and Young, {Robert H.}",
year = "2017",
month = "12",
day = "26",
doi = "10.1097/PAS.0000000000001001",
language = "English (US)",
journal = "American Journal of Surgical Pathology",
issn = "0147-5185",
publisher = "Lippincott Williams and Wilkins",

}

TY - JOUR

T1 - Spermatocytic Seminoma

T2 - A Report of 85 Cases Emphasizing its Morphologic Spectrum Including Some Aspects not Widely Known

AU - Hu, Rong

AU - Ulbright, Thomas

AU - Young, Robert H.

PY - 2017/12/26

Y1 - 2017/12/26

N2 - Spermatocytic seminoma (or, alternatively, spermatocytic tumor) of the testis is rare and errors in pathologic diagnosis are still made. As it has a good prognosis, except when it, rarely, undergoes sarcomatous transformation, accurate diagnosis and differentiating it from usual seminoma and other malignant neoplasms such as lymphoma are crucial. To potentially contribute information of diagnostic aid we reviewed the largest series of cases reported to date to characterize in detail their histologic spectrum. The patients ranged from 30 to 81 years (average, 52 y); 30% were in the fourth decade. The neoplasms ranged from 1.4 to 15 cm (average, 5.7 cm). Most were fleshy, soft, and often lobulated and 11 were edematous or mucoid. Low-power microscopic examination either showed a predominant multinodular (43/85) or diffuse (42/85) pattern. All tumors had the classic “tripartite” cellular population. Five tumors showed a relatively monomorphic population of the intermediate cell type with vesicular chromatin and very prominent nucleoli, at least focally. Two tumors underwent sarcomatous transformation, with 1 having a focus of atypical cartilage. Additional findings, some not previously reported or emphasized, included: (1) frequent edema fluid (87%) often causing spaces, both follicle-like (24%) and irregular (39%), a finding seen in some usual seminomas (but less frequently) and rarely seen in lymphomas; (2) tumor nodules showing partial rims of fibrin (20%); (3) a distinctive arrangement of connecting tumor islands (19%); (4) prominent lymphocytic infiltrates (8%); (5) granulomatous inflammation (1%); (6) striking mitotic activity and apoptosis; (7) intratubular spread (64%); and (8) vessel invasion (11%) and necrosis (8%). Awareness of these aspects may be of importance either at the time of intraoperative evaluation or on final pathologic analysis and help avoid significant errors in diagnosis.

AB - Spermatocytic seminoma (or, alternatively, spermatocytic tumor) of the testis is rare and errors in pathologic diagnosis are still made. As it has a good prognosis, except when it, rarely, undergoes sarcomatous transformation, accurate diagnosis and differentiating it from usual seminoma and other malignant neoplasms such as lymphoma are crucial. To potentially contribute information of diagnostic aid we reviewed the largest series of cases reported to date to characterize in detail their histologic spectrum. The patients ranged from 30 to 81 years (average, 52 y); 30% were in the fourth decade. The neoplasms ranged from 1.4 to 15 cm (average, 5.7 cm). Most were fleshy, soft, and often lobulated and 11 were edematous or mucoid. Low-power microscopic examination either showed a predominant multinodular (43/85) or diffuse (42/85) pattern. All tumors had the classic “tripartite” cellular population. Five tumors showed a relatively monomorphic population of the intermediate cell type with vesicular chromatin and very prominent nucleoli, at least focally. Two tumors underwent sarcomatous transformation, with 1 having a focus of atypical cartilage. Additional findings, some not previously reported or emphasized, included: (1) frequent edema fluid (87%) often causing spaces, both follicle-like (24%) and irregular (39%), a finding seen in some usual seminomas (but less frequently) and rarely seen in lymphomas; (2) tumor nodules showing partial rims of fibrin (20%); (3) a distinctive arrangement of connecting tumor islands (19%); (4) prominent lymphocytic infiltrates (8%); (5) granulomatous inflammation (1%); (6) striking mitotic activity and apoptosis; (7) intratubular spread (64%); and (8) vessel invasion (11%) and necrosis (8%). Awareness of these aspects may be of importance either at the time of intraoperative evaluation or on final pathologic analysis and help avoid significant errors in diagnosis.

KW - germ cell tumor

KW - spermatocytic seminoma

KW - spermatocytic tumor

KW - testicular neoplasms

KW - testis

UR - http://www.scopus.com/inward/record.url?scp=85040315989&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85040315989&partnerID=8YFLogxK

U2 - 10.1097/PAS.0000000000001001

DO - 10.1097/PAS.0000000000001001

M3 - Article

JO - American Journal of Surgical Pathology

JF - American Journal of Surgical Pathology

SN - 0147-5185

ER -