Kumar Harresh, Tanveer Nadeem, Gupta Natasha, Mishra Kiran
Postgraduate Student, Department of Pathology, University College of Medical Sciences , Dilshad Garden, Delhi, India .
Associate Professor, Department of Pathology, University College of Medical Sciences , Dilshad Garden, Delhi, India .
J Clin Diagn Res. 2016 Nov;10(11):ED03-ED05. doi: 10.7860/JCDR/2016/22075.8842. Epub 2016 Nov 1.
Sertoli cell tumours of testes are classified into sertoli cell tumour NOS (not otherwise specified), sclerosing variant and large cell calcifying variant. So far, 90 cases of the large cell calcifying variant have been reported in literature. We describe a rare case of inhibin negative locally invasive large cell calcifying sertoli cell tumour of testis. A 62-year-old man presented with complaints of pain and swelling in right scrotum for 8 months. Ultrasound revealed a right testicular mass with internal vascularity and calcification. Gross examination of right inguinal orchiectomy specimen showed firm to hard mass with yellow areas and calcification seen on cut section. Microscopy revealed a tumour in the testis infiltrating the epididymis and rete testis and reaching up to the skin. Tumour cells were arranged in the form of solid nests, tubules and cords with neutrophilic stromal infiltrate and calcification. Tumour cells had abundant clear to eosinophilic cytoplasm, round nucleus with vesicular chromatin and conspicuous nucleoli. On immunohistochemistry, tumour cells were positive for pan cytokeratin, Epithelial Membrane Antigen (EMA), S-100 protein, desmin, vimentin, neuron specific enolase, and chromogranin. However, it was negative for inhibin alpha, OCT4, CD10, CD99, Melan A. Inhibin negative large cell calcifying sertoli cell tumour is a rare entity.
睾丸支持细胞瘤分为未另行指定的支持细胞瘤、硬化性变体和大细胞钙化变体。迄今为止,文献中已报道90例大细胞钙化变体病例。我们描述了一例罕见的抑制素阴性的睾丸局部浸润性大细胞钙化支持细胞瘤。一名62岁男性因右侧阴囊疼痛和肿胀8个月就诊。超声检查显示右侧睾丸肿块,内部有血管和钙化。右侧腹股沟睾丸切除标本大体检查显示质地硬的肿块,切面可见黄色区域和钙化。显微镜检查显示睾丸内肿瘤浸润附睾和睾丸网,并累及皮肤。肿瘤细胞呈实性巢状、小管状和条索状排列,伴有嗜中性基质浸润和钙化。肿瘤细胞具有丰富的透明至嗜酸性细胞质,圆形细胞核,核仁呈泡状且明显。免疫组化显示,肿瘤细胞对泛细胞角蛋白、上皮膜抗原(EMA)、S-100蛋白、结蛋白、波形蛋白、神经元特异性烯醇化酶和嗜铬粒蛋白呈阳性。然而,它对抑制素α、OCT4、CD10、CD99、黑素A呈阴性。抑制素阴性的大细胞钙化支持细胞瘤是一种罕见的实体。