The Impact of Histological Review on Clinical Management of Testicular Cancer

Segelov, Eva; Cox, Kimberly; McNeil, Edward; Lancaster, Letitia; Rogers, John

doi:10.1111/j.1464-410x.1993.tb16076.x

Cited by 21 publications

(15 citation statements)

References 3 publications

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“…Studies addressing the impact of central histopathologic review of previously diagnosed testicular tumors have demonstrated major discrepancy rates of 4-11%, with the majority of discrepancies attributed to errors in distinguishing seminoma from embryonal carcinoma. [23][24][25] The use of immunohistochemistry may therefore be of value in differentiation of these tumor types.…”

Section: Resultsmentioning

confidence: 99%

D2-40 immunohistochemistry in the differential diagnosis of seminoma and embryonal carcinoma: a comparative immunohistochemical study with KIT (CD117) and CD30

2007

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The distinction between seminoma and embryonal carcinoma based on morphology alone can sometimes be problematic, requiring the use of immunohistochemistry to facilitate diagnosis. D2-40 is a monoclonal antibody that reacts with an oncofetal antigen expressed by fetal germ cells and testicular germ cell tumors. The diagnostic value of D2-40 immunohistochemistry in distinguishing seminoma from embryonal carcinoma has not been determined. D2-40 immunoreactivity was evaluated in a series of testicular germ cell tumors and compared with that of KIT (CD117) and CD30, to assess the relative utility of this marker in discriminating between seminoma and embryonal carcinoma. Forty testicular germ cell neoplasms were examined, which included 19 seminomas, three embryonal carcinomas, three teratomas, one yolk sac tumor, and 14 mixed germ cell tumors. The 14 cases of mixed germ cell tumors contained components of seminoma (n ¼ 7), embryonal carcinoma (n ¼ 11), teratoma (n ¼ 10), yolk sac tumor (n ¼ 2), and choriocarcinoma (n ¼ 1). All cases of pure seminoma and the seminomatous components of mixed germ cell tumors exhibited positive immunoreactivity for D2-40. Focal positivity for D2-40 was also observed in 29% of the embryonal carcinoma samples. D2-40 immunoreactivity in seminomas was characterized by diffuse membrane staining, whereas for embryonal carcinomas, staining was focal and distributed along the apical surfaces of the neoplastic cells. Immunohistochemical staining for KIT was observed in 92% of the seminoma samples and in none of the embryonal carcinomas. Conversely, CD30 expression was identified in 93% of the embryonal carcinoma samples and in none of the seminomas. Other germ cell components showed no immunoreactivity for D2-40, KIT, or CD30. KIT and CD30 are effective immunohistochemical markers in separating seminoma from embryonal carcinoma. Although a highly sensitive marker for seminomas, D2-40 positivity was also observed in a subset of embryonal carcinomas, thus limiting the utility of this antibody for discriminating between these two malignancies. Modern Pathology (2007) 20, 320-325.

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Section: Resultsmentioning

confidence: 99%

D2-40 immunohistochemistry in the differential diagnosis of seminoma and embryonal carcinoma: a comparative immunohistochemical study with KIT (CD117) and CD30

2007

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“…17,18 Indeed, studies demonstrating the value of central histologic review of previously diagnosed testicular malignancies have shown most discrepancies to be the result of errors in distinguishing seminoma from embryonal carcinoma. [19][20][21] The use of immunohistochemical study may therefore be of value in differentiation of these entities.…”

Section: Discussionmentioning

confidence: 99%

TCL1 Protein Expression in Testicular Germ Cell Tumors

Lau

Weiss

2010

American Journal of Clinical Pathology

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We immunohistochemically studied TCL1 protein expression in different histologic types of 63 testicular germ cell tumors: 23 seminomas, 14 embryonal carcinomas, 4 teratomas, 2 yolk sac tumors, and 20 mixed germ cell tumors. The 20 mixed germ cell tumors contained components of seminoma (n = 10), embryonal carcinoma (n = 18), teratoma (n = 16), yolk sac tumor (n = 7), and choriocarcinoma (n = 3). We also examined 40 cases of intratubular germ cell neoplasia, unclassified type (IGCNU). Positive immunoreactivity for TCL1 was observed in 91% of the seminoma samples (30/33) and all IGCNU cases. In contrast, no TCL1 expression was detected among the nonseminomatous germ cell tumors. In the context of testicular germ cell neoplasia, the presence of TCL1 protein appears restricted to IGCNU and seminoma, suggesting association with an undifferentiated state and loss of protein expression with tumor differentiation. Immunohistochemical evaluation of TCL1 expression may have usefulness in substantiating a diagnosis of IGCNU or seminoma and in the separation of seminoma from nonseminomatous germ cell tumors.

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“…Expert pathology review has been shown to be important in the diagnosis of cancer at any age (Presant et al, 1986;Segelov et al, 1993). For example , Segelov et al (1993), in their review of adult testicular tumours, found that in 28 out of 87 (32%) patients, the diagnosis made on referral to the specialist centre differed from the original.…”

Section: Discussionmentioning

confidence: 99%

“…For example , Segelov et al (1993), in their review of adult testicular tumours, found that in 28 out of 87 (32%) patients, the diagnosis made on referral to the specialist centre differed from the original. As paediatric tumours are less common and treatment effects potentially more damaging, specialist diagnostic expertise in referral centres is vital.…”

Section: Discussionmentioning

confidence: 99%

The need for specialist review of pathology in paediatric cancer

Parkes

Muir²,

Cameron³

et al. 1997

Br J Cancer

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Summary A retrospective histopathological review of 2104 cases of solid tumour was carried out to assess the variability in diagnosis of childhood cancer. Cases were subject to three independent, concurrent opinions from a national panel of specialist pathologists. The conformity between them was analysed using the percentage of agreement and the kappa statistic (ic), a measure of the level of agreement beyond that which could occur by chance alone, and weighted kappa (wic), which demonstrates the degree of variation between opinions. The major groupings of the Birch-Marsden classification were used within which tumours were assigned for kappa analysis according to the clinical significance of the differential diagnoses. The mean agreement for all tumours together was 90%; 1C=0.82, wKi=0.82. Retinoblastoma achieved the highest kappa value (1.0) and lymphoma the lowest (0.66). Of the cases, 16.5% had their original diagnoses amended and the panel confirmed the original diagnosis of paediatric pathologists in 89% of cases compared with 78% for general pathologists. The varying levels of agreement between experts confirm the difficulty of diagnosis in some tumour types, suggesting justification for specialist review in most diagnoses. Specialist training in paediatric pathology is also recommended.

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The Impact of Histological Review on Clinical Management of Testicular Cancer

Cited by 21 publications

References 3 publications

D2-40 immunohistochemistry in the differential diagnosis of seminoma and embryonal carcinoma: a comparative immunohistochemical study with KIT (CD117) and CD30

D2-40 immunohistochemistry in the differential diagnosis of seminoma and embryonal carcinoma: a comparative immunohistochemical study with KIT (CD117) and CD30

TCL1 Protein Expression in Testicular Germ Cell Tumors

The need for specialist review of pathology in paediatric cancer

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