Germ cell tumor differential diagnosis: Difference between revisions
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*Choriocarcinoma is rare in both gonads, and those in the ovary must be distinguished from metastatic tumors of placental origin | *Choriocarcinoma is rare in both gonads, and those in the ovary must be distinguished from metastatic tumors of placental origin | ||
*Syncytiotrophoblast cells alone, admixed with other forms of germ cell tumor, still are confused with choriocarcinoma, but this phenomenon, which is much more frequent than choriocarcinoma, lacks the plexiform arrangement of different trophoblast cell types that typifies the latter | *Syncytiotrophoblast cells alone, admixed with other forms of germ cell tumor, still are confused with choriocarcinoma, but this phenomenon, which is much more frequent than choriocarcinoma, lacks the plexiform arrangement of different trophoblast cell types that typifies the latter | ||
*Germinoma of the brain must be differentiated from other lesions in the pineal and suprasellar region, such as glial tumors which include astrocytomas and gangliomas, granular cell tumor, hamartomas, xanthogranuloma, meningiomas, colloid cysts, craniopharyngioma, cysticercosis, metastatic cancer with unknown primary site, pineal tumors, and pituitary macroadenomas <ref name="radio"> Germ cell tumors. Radiopedia(2015) http://radiopaedia.org/articles/central-nervous-system-germinoma Accessed on January 25, 2016</ref> | |||
*Ovarian germ cell tumor must be differentiated from other diseases that cause ovarian mass, such as: <ref name= sba>Shaaban AM, Rezvani M, Elsayes KM, et al. Ovarian malignant germ cell tumors: cellular classification and clinical and imaging features. Radiographics. 2014;34(3):777-801.http://pubs.rsna.org/doi/pdf/10.1148/rg.343130067</ref><ref name= ajk>Jung SE, Lee JM, Rha SE, Byun JY, Jung JI, Hahn ST. CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Radiographics. 2002;22(6):1305-25.http://www.ncbi.nlm.nih.gov/pubmed/12432104</ref> | |||
**Stein-Leventhal syndrome <ref name= sba>Shaaban AM, Rezvani M, Elsayes KM, et al. Ovarian malignant germ cell tumors: cellular classification and clinical and imaging features. Radiographics. 2014;34(3):777-801.http://pubs.rsna.org/doi/pdf/10.1148/rg.343130067</ref><ref name= ajk>Jung SE, Lee JM, Rha SE, Byun JY, Jung JI, Hahn ST. CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Radiographics. 2002;22(6):1305-25.http://www.ncbi.nlm.nih.gov/pubmed/12432104</ref><ref name="pmid22669919">{{cite journal |vauthors=Rozenholc A, Abdulcadir J, Pelte MF, Petignat P |title=A pelvic mass on ultrasonography and high human chorionic gonadotropin level: not always an ectopic pregnancy |journal=BMJ Case Rep |volume=2012 |issue= |pages= |date=June 2012 |pmid=22669919 |doi=10.1136/bcr.01.2012.5577 |url=}}</ref> | |||
**Tubal pregnancy | |||
**Ovarian epithelial tumors | |||
**Ovarian sex-cord stromal tumors | |||
**Tubo-ovarian abscess | |||
*The main differential for testicular mass in young adults is non-seminomatous [[germ cell]] [[tumor]] (NGCT) which usually appear '''more heterogenous''', often with [[cyst]]s and [[calcification]].<ref name="differentialdiagnopsisoftesticulartyeratoma1">Differential diagnosis of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on February 25, 2016</ref> | |||
*[[Lymphadenopathy]] of non-seminomatous [[germ cell]] [[tumor]] may enhance more heterogenously. | |||
*[[lymphoma|Testicular lymphoma]] is the main differential [[diagnosis]] to consider when [[lymphadenopathy|para-aortic lymphadenopathy]] is the presenting finding or in the setting of [[bilateral]] [[Testicle|testicular]] lesions.<ref name="differentialdiagnopsisoftesticulartyeratoma1">Differential diagnosis of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on February 25, 2016</ref> | |||
==References== | ==References== | ||
{{reflist}} | {{reflist}} | ||
Latest revision as of 15:11, 9 September 2019
Germ cell tumor Differential diagnosis: [1]
- Cytoplasmic membrane immunoreactivity for placental alkaline phosphatase and CD117, with usual negativity for AE1/AE3 cytokeratins, is helpful in the diagnosis of germinoma.
- The recently described marker, OCT3/4, a nuclear transcription factor, is especially helpful in the differential of germinoma and embryonal carcinoma with other neoplasms.
- Yolk sac tumor continues to be confused occasionally with clear cell carcinoma of the ovary.
- Glandular ('endometrioid-like') yolk sac tumors mimic endometrioid carcinomas
- Predominant or pure hepatoid yolk sac tumors cause concern for metastatic hepatocellular carcinoma or, in the ovary, primary hepatoid carcinoma, and solid patterns, especially in limited samplings, may be misinterpreted as germinoma
- The usually younger age of patients with yolk sac tumors helps with the differential considerations with the nongerm cell tumors, as do other clinical and microscopic features and selected immunohistochemical stains.
- Choriocarcinoma is rare in both gonads, and those in the ovary must be distinguished from metastatic tumors of placental origin
- Syncytiotrophoblast cells alone, admixed with other forms of germ cell tumor, still are confused with choriocarcinoma, but this phenomenon, which is much more frequent than choriocarcinoma, lacks the plexiform arrangement of different trophoblast cell types that typifies the latter
- Germinoma of the brain must be differentiated from other lesions in the pineal and suprasellar region, such as glial tumors which include astrocytomas and gangliomas, granular cell tumor, hamartomas, xanthogranuloma, meningiomas, colloid cysts, craniopharyngioma, cysticercosis, metastatic cancer with unknown primary site, pineal tumors, and pituitary macroadenomas [2]
- Ovarian germ cell tumor must be differentiated from other diseases that cause ovarian mass, such as: [3][4]
- The main differential for testicular mass in young adults is non-seminomatous germ cell tumor (NGCT) which usually appear more heterogenous, often with cysts and calcification.[6]
- Lymphadenopathy of non-seminomatous germ cell tumor may enhance more heterogenously.
- Testicular lymphoma is the main differential diagnosis to consider when para-aortic lymphadenopathy is the presenting finding or in the setting of bilateral testicular lesions.[6]
References
- ↑ Ulbright TM (2005). "Germ cell tumors of the gonads: a selective review emphasizing problems in differential diagnosis, newly appreciated, and controversial issues". Mod Pathol. 18 Suppl 2: S61–79. doi:10.1038/modpathol.3800310. PMID 15761467.
- ↑ Germ cell tumors. Radiopedia(2015) http://radiopaedia.org/articles/central-nervous-system-germinoma Accessed on January 25, 2016
- ↑ 3.0 3.1 Shaaban AM, Rezvani M, Elsayes KM, et al. Ovarian malignant germ cell tumors: cellular classification and clinical and imaging features. Radiographics. 2014;34(3):777-801.http://pubs.rsna.org/doi/pdf/10.1148/rg.343130067
- ↑ 4.0 4.1 Jung SE, Lee JM, Rha SE, Byun JY, Jung JI, Hahn ST. CT and MR imaging of ovarian tumors with emphasis on differential diagnosis. Radiographics. 2002;22(6):1305-25.http://www.ncbi.nlm.nih.gov/pubmed/12432104
- ↑ Rozenholc A, Abdulcadir J, Pelte MF, Petignat P (June 2012). "A pelvic mass on ultrasonography and high human chorionic gonadotropin level: not always an ectopic pregnancy". BMJ Case Rep. 2012. doi:10.1136/bcr.01.2012.5577. PMID 22669919.
- ↑ 6.0 6.1 Differential diagnosis of testicular seminoma. Dr Marcin Czarniecki and Dr Andrew Dixon et al. Radiopaedia 2016. http://radiopaedia.org/articles/testicular-seminoma-1. Accessed on February 25, 2016