Pathology Unit, Azienda Policlinico Unversità 'L. Vanvitelli, Italy.
Department of Mental and Physical Health and Preventive Medicine, University of Campania "L. Vanvitelli", 80138 Naples, Italy.
Pathol Res Pract. 2024 Jan;253:155069. doi: 10.1016/j.prp.2023.155069. Epub 2023 Dec 30.
Mesothelial tumours of the testicular/paratesticular region are uncommon, poorly characterised and difficult-to-diagnose lesions. They encompass entirely benign proliferations (adenomatoid tumour) and malignant, very aggressive tumours (mesothelioma) whose morphological features can be overlapping, highly variable and confounding. Moreover, testicular/paratesticular mesothelial tumours comprise relatively new entities with indolent behaviour (well-differentiated papillary mesothelial tumour) as well as tumours which cannot be correctly included in any of the aforementioned categories and whose classification is still controversial. The molecular profile of such tumours represents an open issue. In fact, despite the recent discoveries about the genomic landscape of mesothelial proliferations at other sites (pleura, peritoneum), testicular/paratesticular mesothelial tumours, and namely mesotheliomas, are too rare to be extensively studied on large case series and they could arguably hide relevant differences in their molecular background when compared to the more common pleural/peritoneal counterparts.The aim of this review is to provide a guide for the pathological assessment of testicular/paratesticular mesothelial tumours. Herein, we describe the most recent updates on this topic according to the latest (year 2022) World Health Organisation Classification of Urinary and Male Genital Tumours (5th edition) and current literature. The diagnostic criteria, the main differentials and the role of ancillary techniques in the diagnosis of mesothelial testicular/paratesticular tumours are discussed.
睾丸/附睾丸区间皮瘤少见，特征差，诊断困难。它们包括完全良性增生（腺瘤样肿瘤）和恶性、侵袭性极强的肿瘤（间皮瘤），其形态学特征可能重叠、高度多变且令人困惑。此外，睾丸/附睾丸间皮瘤包括行为惰性的相对较新实体（分化良好的乳头状间皮瘤）以及不能正确归入上述任何一类的肿瘤，其分类仍有争议。这些肿瘤的分子特征是一个悬而未决的问题。事实上，尽管最近在其他部位（胸膜、腹膜）的间皮增生的基因组景观方面有了新的发现，但睾丸/附睾丸间皮瘤，特别是间皮瘤，由于数量太少，无法在大量病例系列中进行广泛研究，与更常见的胸膜/腹膜对应物相比，它们的分子背景可能隐藏着相关的差异。本综述的目的是为睾丸/附睾丸间皮瘤的病理评估提供指南。在此，我们根据最新的（2022 年）世界卫生组织泌尿系统和男性生殖器肿瘤分类（第 5 版）和当前文献描述了该主题的最新更新。讨论了间皮性睾丸/附睾丸肿瘤的诊断标准、主要鉴别诊断以及辅助技术在诊断中的作用。
