Extensive fibrosis in mediastinal seminoma is a diagnostic pitfall in small biopsies: two case reports

Liccardi, Anthony R.; Thomas, Kristen; Narula, Navneet; Azour, Lea; Moreira, André L.; Zhou, Fang

doi:10.21037/med-22-15

Cited by 2 publications

(3 citation statements)

References 19 publications

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“…However, when the procedure was repeated, two of those patients were diagnosed with extensive necrotic cancer. It is therefore likely that the necrotic tissue interfered with obtaining a suitable sample during the first biopsy [29]. Curiously, 2 of the undiagnosed samples were taken with a 18G needle, which was used in only three patients.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Needle Biopsy as an Alternative to Chamberlain’s Mediastinotomy and Video-Assisted Thoracoscopic Surgery (VATS) in the Diagnosis of Anterior Mediastinal Neoformations: A Retrospective Analysis

Vischia

Maio

Ferrero

et al. 2023

JCM

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(1) Background: The prompt diagnosis of anterior mediastinal lesions is a challenge due to their often being categorized as malignant tumours. Ultrasound-guided Transthoracic Core Needle Biopsy (US–TCNB) is an innovative technique that is arousing increasing interest in clinical practice. However, studies in this area are still scarce. This study aims to compare the diagnostic accuracy and complication rate of US–TCNB with those of traditional surgical methods—Anterior Mediastinotomy and Video Assisted Thoracoscopic Surgery (VATS)—in patients with anterior mediastinal lesions. (2) Methods: This retrospective study involved patients evaluated between January 2011 and December 2021 who had undergone US–TCNB at the Interdepartmental Unit of Internal and Interventional Ultrasound, Molinette Hospital, Città della Salute e della Scienza, Turin, Italy. Personal data, diagnostic questions, and technical information concerning the bioptic procedure, periprocedural complications and histological reports were collected. (3) Results: Eighty-three patients were included in the analysis. Histological examination was performed in 78 cases, with an overall diagnostic accuracy of 94.0% (sensitivity 94%; specificity 100%). Only in 5 patients was a diagnosis not achieved. Complications occurred in 2 patients who were quickly identified and properly treated without need of hospitalization. The accuracy of US–TCNB was comparable to the performance of the main traditional diagnostic alternatives (95.3% for anterior mediastinotomy, and 98.4% for VATS), with a much lower complication rate (2.4% vs. 3–16%). The outpatient setting offered the additional advantage of saving resources. (4) Conclusions: a US-guided needle biopsy can be considered effective and safe, and in the near future it may become the procedure of choice for diagnosing anterior mediastinal lesions in selected patients.

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Section: Discussionmentioning

confidence: 99%

Ultrasound-Guided Needle Biopsy as an Alternative to Chamberlain’s Mediastinotomy and Video-Assisted Thoracoscopic Surgery (VATS) in the Diagnosis of Anterior Mediastinal Neoformations: A Retrospective Analysis

Vischia

Maio

Ferrero

et al. 2023

JCM

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“…In some cases, single intermingled syncytiotrophoblasts can be present, causing elevated serum β‐hCG 63,86 . Prominent fibrosis as a sign of regression, well known in testicular GCT, 87 has only been described in few cases of PMGCTs with seminomatous components 88–90 …”

Section: Primary Mediastinal Seminomamentioning

confidence: 99%

“…63,86 Prominent fibrosis as a sign of regression, well known in testicular GCT, 87 has only been described in few cases of PMGCTs with seminomatous components. [88][89][90] Immunohistochemical markers for PMSEMs (Figure 1C-H) are SALL4, OCT3/4, SOX17 and CD117. 19,21,67,76 They are also positive for keratins, usually in a dot-like perinuclear staining pattern, which is different from testicular SEM.…”

Section: Histological Subtypesmentioning

confidence: 99%

Primary germ cell tumours of the mediastinum: A review with emphasis on diagnostic challenges

Fichtner,

Marx,

Ströbel

et al. 2023

Histopathology

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This article will review current aspects of the histopathological, immunohistochemical and molecular analysis of primary mediastinal germ cell tumours (PMGCTs) as well as their aetiological, epidemiological, clinical and therapeutic features. PMGCTs represent an important differential diagnosis in the spectrum of mediastinal tumours, and their diagnosis is usually made on small tissue samples from core needle biopsies in combination with diagnostic imaging and serum tumour markers. As in lymphomas, a small biopsy is often the only viable tumour sample available from these patients, as they receive chemotherapy prior to eventual surgical resection. Pathologists therefore need to apply an efficient combination of immunohistochemical markers to confirm the diagnosis of a PMGCT and to exclude morphological mimics.

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Extensive fibrosis in mediastinal seminoma is a diagnostic pitfall in small biopsies: two case reports

Cited by 2 publications

References 19 publications

Ultrasound-Guided Needle Biopsy as an Alternative to Chamberlain’s Mediastinotomy and Video-Assisted Thoracoscopic Surgery (VATS) in the Diagnosis of Anterior Mediastinal Neoformations: A Retrospective Analysis

Ultrasound-Guided Needle Biopsy as an Alternative to Chamberlain’s Mediastinotomy and Video-Assisted Thoracoscopic Surgery (VATS) in the Diagnosis of Anterior Mediastinal Neoformations: A Retrospective Analysis

Primary germ cell tumours of the mediastinum: A review with emphasis on diagnostic challenges

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