[Cytomorphological characteristics of ovarian dysgerminoma]. / Tsitomorfologicheskie priznaki disgerminom iaichnika.

Cytomorphological signs of ovarian dysherminoma are distinguished on suboperation material from 7 patients. Scrapings from removed ovarian tumors were stained after N. G. Alexeev and Pappenheim. Dysherminoma cytograms were characterized mainly by a combination of three cell types: large sharply polymorphic epithelioid with multiple clearly-seen nuclei, connective tissue, and lymphocyte-like cells.

Germ cell tumors of the basal ganglia and thalamus.

The clinicopathological findings in 6 patients with germ cell tumors originating in the basal ganglia and thalamus are presented. Clinical, biological and diagnostic features were somewhat different from germ cell tumors in the pineal region. Early and comprehensive treatment is recommended because of the possible presence of nongerminomatous germ cell components.

Lymphoglandular bodies in fine-needle aspiration cytology smears.

Lymphoglandular bodies (hyaline bodies or lymphoid globules), when found in cytology smears from fine-needle aspirates, have long been accepted as being diagnostic of lymphoid tissue. To investigate the validity of this association as it relates to malignant tumors, we examined cytologic smears from 132 fine-needle aspirates of malignant neoplasms. Three experienced observers independently scored Diff-Quik-stained smears as to cellularity and number and size of lymphoglandular bodies. Discrepancies were resolved by consensus. Results of the fine-needle aspiration biopsies revealed 6 of 104 nonlymphoid malignancies with easily identifiable lymphoglandular bodies (defined as > 2 lymphoglandular bodies per high-power field) and 3 with numerous lymphoglandular bodies (> 10 per high-power field). These tumors consisted of two cases of small-cell carcinoma, four non-small-cell carcinomas, one ganglioneuroblastoma, one melanoma, and one seminoma. The tumors had few, if any, lymphocytes. Of the 28 lymphomas, 5 had easily identifiable lymphoglandular bodies and 19 had numerous lymphoglandular bodies. Although lymphoglandular bodies in the background of cytologic smears taken from malignant tumors are useful in alerting the pathologist to the possibility of lymphoma, there are exceptions.

In situ observation of inflammatory cell-tumor cell interaction in human seminomas (germinomas): light, electron microscopic, and immunohistochemical study.

The precise functional significance of the inflammatory cells that infiltrate seminomas remains poorly understood. The present study analyzed 15 cases of testicular and extragonadal seminomas (germinomas) by light and electron microscopy, as well as by immunohistochemical methods, with emphasis on the inflammatory cell-tumor cell interaction. Ultrastructurally, in all 15 cases the lymphocytes (mainly consisting of small lymphocytes) were found to be in intimate contact with the intact tumor cells and with those that displayed damage of varying degree. In particular, relatively early damage, such as local loss of the membrane and/or cytoplasm, occurred at the contact regions. Often, the lymphocytes penetrated deeply into the cytoplasm, even into the nucleus of the tumor cell. In spite of the severe damage to the tumor cells, the lymphocytes were themselves intact. The stromal cells contacted by lymphocytes did not show damage. The tumor cells were in contact with epithelioid cells of granulomas in six cases and scattered macrophages in 11 cases showed damage similar to that seen in tumor cells in contact with lymphocytes. The great majority of the lymphocytes were UCHL1-positive cells. L26- or Leu-7-positive cells were rarely found. The epithelioid cells and scattered macrophages were positive for MAC387. The present morphologic study suggests that the infiltrating lymphocytes, epithelioid cells (probably derived from macrophages), and macrophages may be directly cytotoxic to the tumor cells in the microenvironments of testicular and extragonadal seminomas (germinomas).

Placental-like alkaline phosphatase and DNA flow cytometry in spermatocytic seminoma.

Immunohistochemical analysis was done on 7 testicular tumors classified as spermatocytic seminoma (SS) and 25 classic seminomas. Except for a few scattered cells, the spermatocytic seminomas were negative for placental-like alkaline phosphatase (PLAP); the classic seminomas were all positive for this enzyme. The SS also were negative for alpha-fetoprotein (AFP), beta-human chorionic gonadotropin (hCG), and leukocyte common antigen (LCA). The ploidy of the seven tumors of SS was as follows: two, diploid; two, near-diploid; one, tetraploid; one, aneuploid; and one, uninterpretable. The essentially negative staining of SS for PLAP was strikingly different from the pattern in classic seminoma. Thus, staining for this enzyme is useful for making the differential diagnosis between classic seminoma and SS. To differentiate between malignant lymphoma and SS, staining for leukocyte common antigen is helpful.

Dysgerminoma of the ovary. Cytologic, histologic and electron microscopic study of a case.

A case of ovarian dysgerminoma is reported. Both histology and cytology showed cells with distinctive anisokaryosis and large, sometimes bizarre, nucleoli as the most striking feature. A lymphocytic infiltration was present. Electron microscopy showed large convoluted nucleoli, structures resembling so-called "annulated lamellae" and glycogen particles, features that are typical of a germ-cell tumor. The cytologic, histologic and ultrastructural investigations revealed a dysgerminoma; that diagnosis was not certain on the frozen sections.

Flow cytometry analysis of ploidy and proliferation activity in classical and spermatocytic seminoma.

In a series of 49 cases of seminomas, namely 19 classical seminomas, 21 seminomas with syncytiotrophoblastic cells and 9 spermatocytic seminomas, DNA ploidy and S-phase cell fraction of the cell cycle were estimated in paraffin-embedded histopathological material. DNA aneuploidy was detected in 16/19 classical seminomas (84%), in all seminomas with syncytiotrophoblastic cells (100%) and in 6/9 spermatocytic seminomas (67%). In three cases two distinct aneuploid stemlines were detected, in four cases regional variations in ploidy level were observed, clearly proving cellular heterogeneity within the studied specimens. No significant differences in distribution of ploidy levels of aneuploid tumors were detected either between distinct groups of seminomas or in relation to the age of the patients. On the other hand, mean values of S-phase cell fractions in our material offer statistically highly significant differences between defined groups of tumors. Spermatocytic seminomas had the highest level of proliferation activity, which is in contrast with the clinicopathological observations (relatively slow growth, rare occurrence of metastases, local malignancy). The results of proliferation activity analysis and the relatively highest incidence of diploid tumors support the theory of different origin of spermatocytic seminomas in comparison with other germ cell tumors.

Pineal germinomas and testicular seminoma: a comparative ultrastructural study with special references to early carcinomatous transformation.

We have investigated the ultrastructural characteristics of 16 cases of pineal germinomas and compared them with those of 18 cases of testicular seminomas. Glandular differentiation of tumor cells was found in both though it was more consistently noted in pineal germinomas than in testicular seminomas. This feature was interpreted to represent early carcinomatous transformation of germinoma cells. It not only explains the difficulties occasionally encountered in distinguishing germinoma and its anaplastic variant from embryonal carcinoma, but also has implications for our understanding of germ cell neoplasia, particularly the place of germinoma/seminoma in the nosology of such tumors.

Basement membrane components secreted by mouse yolk sac carcinoma cell lines.

Three new cell lines (NE, ME, LRD) were cloned from mouse-embryo-derived teratocarcinomas and characterized on the basis of developmental, ultrastructural, and cytochemical criteria as nullipotent embryonal carcinoma (EC), pure parietal yolk sac (PYS) carcinoma and mixed parieto-visceral yolk sac carcinoma respectively. Cell lines NE and ME were composed of a monomorphous cell population; however, the morphology of ME was growth-medium-dependent. LRD was composed of a heterogeneous cell population and formed embryoid bodies. NE secreted soluble laminin, osteonectin, entactin and fibronectin but did not form visible pericellular matrix. ME formed pericellular matrix which was composed of laminin and entactin, but did not contain fibronectin. The LRD cells formed pericellular matrix which was composed of laminin, entactin and fibronectin. Whereas laminin from ME and LRD reacted with polyclonal antibodies and a monoclonal antibody to parietal yolk sac laminin, the laminin from NE cells was unreactive with the monoclonal antibody. Osteonectin was found in the supernatant of LRD and ME, but could not be demonstrated immunohistochemically in the extracellular matrix. We conclude that some extracellular matrix components, such as laminin and fibronectin, are produced not only by yolk sac carcinoma cells but by nullipotent EC as well, although the latter do not assemble them into extracellular matrix. Laminin produced by EC is immunochemically different from laminin secreted by yolk sac carcinoma. The extracellular matrix produced by mixed parieto-visceral yolk sac carcinoma is different from the matrix laid down by the pure PYS in that the latter does not contain fibronectin. The lack of osteonectin in the extracellular matrix of yolk sac carcinoma cells indicates that not all polypeptides secreted by these cell lines are incorporated into the extracellular matrix. The new cell lines described in this paper differ with regard to their capacity to form extracellular matrix and secrete its various components. Hence they could be used for further studies of basement membrane assembly in vitro.

Spermatocytic seminoma associated with rhabdomyosarcoma.

A case of spermatocytic seminoma intimately associated with rhabdomyosarcoma is reported. The patient, a 51-year-old man, presented with a two-year history of right-sided testicular enlargement. Orchiectomy was performed, and a large testicular tumor was excised. Further investigations during hospitalization revealed lung, liver, and retroperitoneal lymph node metastases. Further therapy was refused, and the patient died at home two months after orchiectomy. Autopsy was not permitted. Although the great majority of spermatocytic seminomas occur in pure form, do not metastasize, and have very good prognosis, in addition to the present case, seven cases of spermatocytic seminoma associated either with rhabdomyosarcoma or undifferentiated sarcoma have been reported. Presence of the sarcomatous element is associated with aggressive behavior, metastatic disease, and very poor prognosis. It is considered that the sarcomatous element develops from the spermatocytic seminoma by anaplastic transformation.

Metachronous soft-tissue masses in children and young adults with cancer: correlation of histology and aspiration cytology.

We describe a series of 28 fine needle aspiration biopsies (FNAB) of soft tissue from 22 patients. Four patients had two separate FNABs, and one had three aspiration procedures. The patient population was limited to children and young adults (age range, 2 months to 29 years; mean, 16 years) who were known to have diverse forms of cancer, and who subsequently developed a mass in the peripheral soft tissues (including breast). The interval between the time of diagnosis of the primary malignant neoplasm and FNAB ranged from 1 day to 17 years (mean, 39 months). All FNAB diagnoses were confirmed by subsequent surgical open biopsy or clinical follow-up greater than 1 year. No complications occurred from the procedure. The cytomorphology is presented in selected cases and correlated with the patient's original tissue histopathology. Twenty aspirates were diagnosed as cytologically malignant, one as suspicious for malignancy. Seven were considered benign. None were unsatisfactory. One false-positive and no false-negative cytologic diagnoses were obtained. The overall accuracy of FNAB diagnoses was 96%, while sensitivity was 100% and specificity 88%. Sites of aspiration included soft tissues of the head and neck (seven cases), trunk (eight cases), breast (four cases), and extremities (nine cases). Malignant cytologic diagnoses included sarcoma (thirteen), seminoma (two), lymphoma/leukemia (two), melanoma (one), undifferentiated neoplasm (one), and neuroblastoma (one). Electron microscopy of aspirated cells was used to confirm the diagnosis in two cases. Fine needle aspiration biopsy of soft tissue masses from children and young adults with cancer demonstrates a high diagnostic accuracy, and its use is justified in this population.

Nucleolar organizer regions in seminoma and intratubular malignant germ cells.

Nucleolar organizer regions (NORs), as demonstrated by a silver-colloid staining technique, have been counted in 71 primary testicular seminomas (typical seminoma (TS) 31, high mitotic index seminoma (HMIS) 24, and spermatocytic seminoma (SS) 16) and ten seminomas metastatic to retroperitoneal lymph nodes. Mean NOR counts were 14.36 for TS; 17.66 for HMIS; 10.89 for SS; and 17.70 for metastatic seminoma. Analysis of data using Student's unpaired t-test showed a significant difference between the NOR counts obtained from TS, HMIS, and SS. Furthermore, there was a statistically significant difference between NOR counts in metastatic seminoma when compared with TS and SS but not HMIS. The association between tumor proliferation rates and intranuclear NOR numbers is discussed. In addition to a numerical variation, the NOR distribution throughout the nucleus was noted to be different in SS when compared with the other varieties of seminoma studied. The pattern observed had some features similar to those seen in cells of the spermatogenic series. The NOR technique was also applied to 19 cases of intratubular malignant germ cells (ITMGC). It was shown that these malignant cells were easily identified using this staining method and that the NOR distribution was similar to that seen in TS and HMIS. The mean NOR count in ITMGC was 16.41. This was significantly different from that of TS but not HMIS.

Fine-needle aspiration biopsy of seminoma and dysgerminoma: cytologic, histologic, and electron microscopic correlations.

Cytomorphologic features in a series of fine-needle aspiration biopsies from eight patients with seminoma or dysgerminoma were reviewed, and the findings were further correlated with histopathologic and ultrastructural appearances. Three cell types were encountered. Type I was least differentiated and least frequent. Type II was most frequent and had well-developed cytoplasm rich in organelles. Type III was similar to type II but also contained abundant cytoplasmic glycogen. In cytology smears, type III cells contained large punched-out cytoplasmic vacuoles corresponding to the areas of glycogen deposition. The background contained a variable mixture of inflammatory cells including lymphocytes, plasma cells, epithelioid cells, and epithelioid granulomas. The significance of these findings in the diagnosis of seminoma or dysgerminoma and the distinction from other germ-cell and non-germ-cell tumors is briefly discussed.

A testicular seminoma in a rabbit.

The histological, ultrastructural and biological features are described of a spontaneously occurring seminoma in the testis of a male domestic rabbit. The tumour was structurally similar to seminomas in other animal species.

Fluorescence histochemistry of RNA in human pituitary adenomas.

Acridine orange (AO)-RNA fluorescence was studied histochemically in 9 normal human pituitary glands, in 26 secretory and nonsecretory pituitary adenomas, and in a dysgerminoma. Six adenomas showing immunoreactivity for prolactin showed intense orange-red cytoplasmic fluorescence; 6 other tumours exhibiting immunoperoxidase activity of growth hormone showed less intense AO-RNA fluorescence, and 5 adrenocorticotropic hormone-containing adenomas showed still weaker orange fluorescence. Among the chromophobe adenomas without immunoreactivity for secretory products, 5 had uniformly very weak AO-RNA fluorescence, while in 4 other a few scattered cells with strong AO-RNA fluorescence were detected among the majority of weakly fluorescent cells. The pituitary dysgerminoma contained many cells with strong AO-RNA fluorescence. Electron microscopy of these cases showed good correlation of cytoplasmic concentration of ribosomes with AO-RNA fluorescence of the adenomas. AO is useful as an inexpensive, simple supplementary stain for frozen or paraffin sections of pituitary tumours to infer secretory activity as a correlate of RNA concentration and to demonstrate a secretory potential in some cells of hormonally inactive tumours.

Gonadoblastoma. Immunohistochemical and ultrastructural observations.

Gonadoblastoma is an unusual tumor that typically arises in a streak gonad or an abnormal testis of an individual having a Y chromosome. It is a mixed tumor composed of primitive germ cells and sex cord cells arranged in characteristic nests containing hyaline material. Whether the supportive gonadal sex cord cells are granulosa or Sertoli cells has not been clearly established, but one prior ultrastructural study favored Sertoli cell differentiation. Our studies indicate that the intermediate filaments of these cells react to monoclonal antibodies raised against cytokeratin and vimentin. The hyaline material reacts strongly with anti-laminin antibodies, indicating basement membrane material. Additionally, rodlike condensations of the intermediate filaments (historically called Charcot-Böttcher "crystalloids") were similar to those seen in the Sertoli cells of a series of postpubescent testes examined ultrastructurally. These findings support the Sertoli-like differentiation of these cells.