Hui Monalisa, Tandon Ashwani, Uppin Shantveer G, Paruchuri R K
Department of Pathology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, Andhra Pradesh, India.
Indian J Pathol Microbiol. 2012 Oct-Dec;55(4):531-4. doi: 10.4103/0377-4929.107803.
Florid vascular proliferation in teratoma is rare morphological presentation. We present a case of mediastinal germ cell tumor masquerading as a vascular neoplasm in a 14-year-old male who presented with right hemithoracic mass. The initial histopathology of resected mass was suggestive of vascular neoplasm. Fine needle aspiration cytology (FNAC) of right axillary mass with immunohistochemistry on cell block was consistent with metastatic mixed germ cell tumor. Repeat extensive sectioning of the resected mediastinal mass showed focal viable tumor with mainly teratomatous component. Further enquiry into the history revealed patient having received prior chemotherapy; this he received in another hospital before being admitted to our hospital for surgical resection of the mass. The florid vascular proliferation may represent postchemotherapy change or a rare component of germ cell tumor possibly resistant to preoperative chemotherapy.
畸胎瘤中显著的血管增生是一种罕见的形态学表现。我们报告一例14岁男性纵隔生殖细胞肿瘤，表现为血管性肿瘤，以右半胸肿物就诊。切除肿物的初始组织病理学提示为血管性肿瘤。右腋窝肿物的细针穿刺细胞学检查（FNAC）及细胞块免疫组化结果符合转移性混合性生殖细胞肿瘤。对切除的纵隔肿物再次进行广泛切片检查显示有局灶性存活肿瘤，主要为畸胎瘤成分。进一步询问病史发现患者曾接受过化疗；他在被我院收治行肿物手术切除前，在另一家医院接受了化疗。显著的血管增生可能代表化疗后的改变，或是生殖细胞肿瘤中对术前化疗可能耐药的罕见成分。
