IMPORTANCE OF DETERMINATION OF DIFFERENT HISTOLOGIC COMPONENTS OF TESTICULAR GERM CELLS
Autori:
Božo Krušlin, Marijana Turčić, Hrvoje Čupić, Irena Novosel, Ante Reljić, Boris Ružić, Mladen Belicza
Sažetak
Sažetak. Tumori zametnih stanica predstavljaju 95% svih tumora testisa i često su sastavljeni od više različitih komponenata. Najbolju prognozu imaju seminomi, dok prognoza neseminomskih tumora ovisi o zastuplj enosti i vrsti različitih komponenata. Cilj je ovog rada odrediti zastupljenost i histološki tip različitih sastavnica tumora zametnih stanica testisa dijagnosticiranih u razdoblju 1992-2000. U istraživanom razdoblju bio je ukupno 131 takav tumor od čega su bila 72 (55,0%) neseminomska i 59 (45,0%) seminomskih tumora. Od 72 neseminomska tumora 4 su bila sastavljena samo od jedne komponente, dok je 68 bilo miješanih. Neseminomski tumori su najčešće sadržavali komponente embrionalnog karcinoma (9l,7%), teratoma (70,8%) i yolk sac tumora (33,3%). Najčešća kombinacija neseminomskog tumora sastojala se od embrionalnog karcinoma i teratoma u 28 (41 ,2%) slučajeva. Seminom je dijagnosticiran u 59 tumora, ali je komponenta sen1inoma nađena u još 19 (26,4%) slučajeva miješanih tumora zametnih stanica testisa. Dodatna analiza dubljih rezova uz pomoć imunohistokemij skih metoda (citokeratin, CD30, alfa-fetoprotein, beta-hCG, PLAP i hPL) pokazala je prisutnost 20 slučajeva s komponentama koje nisu bile dijagnosticirane u originalnoj biopsiji. Ovakav nalaz pokazuje važnost analize više rezova i važnost primjene imunohistokemijskih metoda u tumora zametr1ih stanica testisa.
Summary
Summary. Testicular germ cell tumors represent about 95% of all testicular tumors. They are often composed of many different components. Seminoma usually has a favorable course but the prognosis of mixed germ cell tumors is depending on the type and proportion of different histologic components. The aim of this study was to determine the proportion and histologic type of various components of testicular germ cell tumors diagnosed in the period 1992–2000. In this period there were 131 testicular germ cell tumors with 72 (55.0%) nonseminomatous and 59 (45.0%) seminomatous tumors. Of all nonseminomatous tumors, 4 were composed of one component only, and 68 contained different components. Nonseminomatous tumors contained most commonly embryonal carcinoma (91.7%), teratoma (70.8%) and yolk sac tumor (33.3%) components. The most frequent combination of mixed germ cell tumors was composed of teratoma and embryonal carcinoma in 28 (41.2%) cases. Seminoma was found in 59 cases as pure seminoma and in 19 (26.4%) additional cases represented a component of testicular mixed germ cell tumor. Analysis of deeper sections by means of HE stained slides and immunohistochemistry (cytokeratin, CD30, α-feto- protein, beta-HCG, PLAP and hPL) revealed 20 cases with components that were not described in original biopsy findings. We may conclude that the analysis of many sections using immunohistochemistry is necessary to identify all tumor components.
