Qap (Anatomical Pathology) 

QAP Peer Review

AP207
Case History: M/41. Left testicular mass
Intended diagnosis: Choriocarcinoma with intratubular germ cell neoplasia. Contributed by:MST
Code Diagnosis Comment Score
anonymous Choriocarcinoma (100%), with intratubular germ cell neoplasia Further sampling to exclude other germ cell tumour components.  100
anonymous Testis: Embryonal carcinoma with intratubular germ cell neoplasia nil  60
anonymous Germ cell tumour, mixed - with choriocarcinoma and possible embryonal carcinoma element (100%). Need to sample extensively, embed all of the tumour to look for other possible germ cell element etc. The surrounding testis shows features of severe atrophy and this raises the suspicion of a maldescended testis (is the other testis normal?). In addition there are changes of intratubular germ cell neoplasia, unclassified type (IGCNU) adjacent to the tumour. Cytokeratins, CD30, AFP, HCG etc to confirm embryonal carcinoma and other possible choriocarcinomatous or yolk sac elements. Immunohistochemistry for PLAP, CD117(c-kit) to confirm IGCNU.  95
anonymous Choriocarcinoma; intratubular germ cell neoplasia. Suggest thorough sampling to look for other germ cell tumor components.  100
anonymous Choriocarcinoma 100% Sampling to look for other germ cell components. Tumor cells will be highlighted by HCG stain.  95
anonymous Choriocarcinoma. (100%) nil  95
anonymous Testis - Choriocarcinoma 100% nil  95
anonymous Choriocarcinoma (100%) Need extensive sampling to look for other germ cell tumours  95
anonymous Choriocarcinoma 100% nil  95
anonymous Choriocarcinoma in testis with sign of atrophy and hyperplasia of rete testis with intratubular germ cell neoplasia. nil  100
anonymous Left testis for section - CHORIOCARCINOMA (W.H.O.)(malignant teratoma trophoblastic, B.T.T.P.), no other germ cell component, background atrophic seminiferous tubule, cannot rule out undescended testis, no intratubular germ cell neoplasia. The diagnosis can be confirmed by immunohistochemical staining for HCG.  95
anonymous Germ cell tumor: mainly choriocarcinoma There are also small components of intratubular germ cell neoplasia and pagetoid tumor spread in rete testis. Immunostaining (HCG and PlAP) may be performed for delineation of different components of germ cell tumor.  100
anonymous Choriocarcinoma with intratubular germ cell neoplasia in rete testis 100% nil  100
anonymous Choriocarcinoma (100%) Perform hCG stain for confirmation; sample more blocks to look for other germ cell component.  95
anonymous Choriocarcinoma with intratubular germ cell neoplasia More sampling to exclude mixed germ cell tumour.  100