Human chorionic gonadotrophin and alpha‐fetoprotein in testicular germ cell tumours: a retrospective immunohistochemical study

Abstract

A series of testicular germ cell tumours (46 seminomas and 27 non-seminomas) was studied immunohistochemically with regard to the presence of alpha FP and HCG. In three seminomas, HCG reactive syncitiotrophoblast-like giant cells (STLG) were found. Immunoreactive alpha FP did not occur in seminomas. In differentiated mature teratomas HCG or alpha FP could not be demonstrated. In embryonal carcinomas with or without teratoma (MTI/MTU/MTT) HCG immunoreactivity was found in 83%, usually localized in STLG. In 75% of these tumours alpha FP could be demonstrated. This protein was localized in foci of endodermal sinus or yolk sac differentiation, but also in single cells and cell clusters in areas of embryonal carcinoma. In some cases syncitial cells were present which contained both HCG and alpha FP. Immunostaining of tumour markers appeared not to provide important additional criteria for classification of these tumours in the currently available classifications. The significance of HCG containing STLG in seminomas deserves further investigation. Prospective studies of embryonal carcinoma with or without teratoma (MTI/MTU/MTT) will be necessary to evaluate the possible prognostic importance of the presence of alpha FP or HCG or both.

Role of Human Chorionic Gonadotropin in Patients with Pure Seminoma

“…Additionally, mononuclear seminoma cells, rather than giant cells, may be the major site of ß-hCG produc tion in these patients, as already observed by Bosman et al [30], Jacobsen et al [25], and Morgan et al [31], Mononuclear seminoma cells containing ß-hCG could perhaps be found in more patients with ß-hCG-positive seminoma if an even more intensive work-up of the histo logical slides of sometimes very large tumors were carried out.…”

The biological and clinical significance of HCG-containing cells in seminoma

“…In agreement with previous workers (Heyderman, ,ourse. Incidence This is the first large series in which the incidence of HCG-containing cells in seminomas is described, the only other comparable series being that of Bosman et al (1980), who found an incidence of 3/46 (7%). In other publications it is not clear whether all seminomas have been investigated immunocytochemically or whether this technique has been restricted to those tumours in which syncytiotrophoblasts have been seen on H & E stained sections (Hedinger et al, 1979) or those associated with elevated serum levels of HCG (Javadpour et al, 1978).…”

“…(Hedinger et al, 1979), but their definition and incidence in different series have varied (Friedman & Moore, 1946;Dixon & Moore, 1952;Friedman & Pearlman, 1970;Mostofi & Price, 1973;Thackray & Crane, 1976). Some studies include all giant cells except the Langhans cell, whereas others confined themselves to the typical syncytiotropho- showing the morphological features of syncytiotrophoblasts (Javadpour et al, 1978;Kurman et al, 1979;Mostofi, 1980), or to be localised commonly in these cells and occasionally seen in seminoma In giant cells ("mulberry" cells) (Heyderman, 1978;Bosman et al, 1980) and rarely in "ordinary lization of HCG in some seminomas has seminoma cells" (Morgan et al, 1982). )ns for their histological classification and…”

“…This figure is within the range of published data based on morphological appearances or HCG production. Since, as shown in Table II (Javadpour et al, 1978;Hedinger et al, 1979;Mostofi, 1980;Bosman et al, 1980 (Dixon & Moore, 1952;Wilson & Woodhead, 1972;Maier & Sulak, 1973 (Cochran et al, 1975;Bartsch et al, 1979;Javadpour, 1980Javadpour, , 1983 but there is still no concensus as to its prognostic significance. Lange et al (1980) suggest that this finding in association with metastatic seminoma is a poor prognostic sign and indicates the use of chemotherapy.…”

Pluripotential Germinal Tumor Tissue as a Source of Transplantable Graft Tissue

“…In contrast to the animal model, germinomas rarely differ entiated exclusively into benign teratomas, (ii) No human GCT in vitro has been induced to form nervous tissue, nor has the capability of in tercellular communication, chimerism and function been shown, (iii) GCT employ certain embryonal 'defenses' against immune attack, such as nonexpression of the histocompatibility antigens [14,28], anti genic m odulation, as in the 'nonpermissiveness' of these undifferen tiated cells to viral infection [15], and secretion of lymphotoxic sub stances such as progesterone [4,23]. Control of undesired behavior on the part of implanted germinal malignant cells would require invasive and toxic measures.…”