Anagnostaki L, Krag Jacobsen G, Horn T, Sengeløv L, Braendstrup O
Department of Pathology, Glostrup.
APMIS. 1992 Sep;100(9):809-16. doi: 10.1111/j.1699-0463.1992.tb04004.x.
A case of melanotic neuroectodermal tumour (MNT), or so-called retinal anlage tumour, as a predominant component of an immature testicular teratoma is presented. The patient was a 17-year-old man who furthermore had a mature mediastinal teratoma. The MNT was composed mainly of two cell types: small immature neuroblast-like cells and large columnar or cuboidal epithelial-like cells with or without melanin granules. The tumour cells were arranged in solid formations, nests, cords, alveolar and pseudoglandular structures with cleft-like or glomeruloid-like spaces. Myogenic differentiation was found in minor foci. Immunohistochemistry showed both neuroepithelial and mesenchymal features with positive staining reaction for neuron-specific enolase (NSE), S-100 protein (S-100), melanoma antigen (HMB45), cytokeratin and vimentin. Vimentin, desmin and actin were present in the myoid cells. To the best of our knowledge this is the first reported case of MNT originating in the testis. As this tumour component occurred in an immature teratoma, neuroectodermal differentiation of germ cell origin is considered most likely.
本文报告一例以黑素沉着性神经外胚层肿瘤（MNT），即所谓的视网膜原基肿瘤，作为未成熟睾丸畸胎瘤主要成分的病例。患者为一名17岁男性，此外还患有成熟的纵隔畸胎瘤。MNT主要由两种细胞类型组成：小的未成熟神经母细胞样细胞和大的柱状或立方上皮样细胞，后者有或无黑色素颗粒。肿瘤细胞呈实性结构、巢状、条索状、肺泡状和假腺管状结构排列，伴有裂隙样或肾小球样间隙。在少数灶性区域发现有肌源性分化。免疫组织化学显示具有神经上皮和间充质特征，神经元特异性烯醇化酶（NSE）、S-100蛋白（S-100）、黑色素瘤抗原（HMB45）、细胞角蛋白和波形蛋白染色呈阳性反应。波形蛋白、结蛋白和肌动蛋白存在于肌样细胞中。据我们所知，这是首例报道的起源于睾丸的MNT病例。由于该肿瘤成分发生于未成熟畸胎瘤中，最有可能的是生殖细胞来源的神经外胚层分化。
