Germinoma pathophysiology
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Pathophysiology
Gross pathology
On gross examination, the external surface is smooth and bosselated (knobby), and the interior is soft, fleshy and either cream-coloured, gray, pink or tan.
Microscopic pathology
Microscopic examination typically reveals uniform cells that resemble primordial germ cells. Typically, the stroma contains lymphocytes and about 20% of patients have sarcoid-like granulomas. The tumor is uniform in appearance, consisting of large, round cells with vesicular nuclei and clear or finely granular cytoplasm that is eosinophilic. Pure germinomas are composed of large polygonal undifferentiated cells with abundant cytoplasm arranged in nests separated by bands of connective tissue. The histologic appearance of Nongerminomatous germ cell tumors (NGGCTs) varies depending upon the specific cell types present.
Pathogenesis
Central nervous cell germ cell tumors (GCTs) are believed to arise from nests of embryonic cells arrested during their migration in fetal development in the midline structures. As a result, CNS GCTs are found in midline sites, especially in the suprasellar and pineal gland regions.