Dysgerminoma

Patients with malignant disease show increased LD activity in serum up to 70% of patients with fiver metastases and 20% to 60% of patients with other nonhepatic metastases have elevated total LD activity. Notably elevated LD-1 is observed in germ cell tumors (61% of cases), such as teratoma, seminoma of the testis, and dysgerminoma of the ovary. Patients with seminoma have a raised LD-1 m 63% of cases compared with 60% in nonseminoma cases. The percent of patients with increased LD-1 depended on the stage of the disease. LD-1 appeared to be a useful predictor of outcome in patients with testicular germ cell tumors. 

Cheng L, Thomas A, Roth LM, et al. OCT4 a novel biomarker for dysgerminoma of the ovary. Am J Surg Pathol. 2004 28 1341-1346. 

Cossu-RoccaP, Jones TD, Roth LM, etal. Cytokeratin and CD30 expression in dysgerminoma. Hum Pathol. 2006 37 1015-1021. 

Dysgerminoma is the ovarian analogue of testicular seminoma. It consists of large polygonal tumor cells with round vesicular nuclei with conspicuous nucleoli. 

FIGURE 18.39 Dysgerminoma shows (A) strong cytoplasmic and membrane staining for placental alkaline phosphatase (FLAP) and (B) strong membrane staining for GD11 7 (c-k/t). 

PLAP, placental alkaline phosphatase CDl 1 7 (c-kit), membrane staining CK, cytokeratin, rare dysgerminomas showweak staining, with AEl /AE3 embryonal carcinoma shows membrane staining and yolk sac tumor cytoplasmic staining LCA, leukocyte common antigen MPO, myeloperoxidase. 

FIGURE 18.40 Dysgerminoma. Strong nuclear staining for Oct-4, as shown here, is characteristic of dysgerminoma. In the ovary, the only other tumor types that stain for this marker are embryonal carcinoma and the germ cells in gonadoblastoma. 

FIGURE 18.43 Mixed germ cell tumor. An immunostain for cyto-keratin AE1 /AE3 helps to delineate the various elements. Foci of yolk sac tumor (top) show strong cytoplasmic staining for keratin. The surrounding dysgerminoma is keratin negative. 

Lifschitz-Mercer B, Walt H, Kushnir I, et al. Differentiation potential of ovarian dysgerminoma An immunohistochemical study of 15 cases. Hum Pathol. 1995 26 62-66. 

Hoei-Hansen GE, Kraggerud SM, Abeler VM, et al. Ovarian dysgerminomas ate chatactetised by frequent KIT mutations and abundant exptession of plutipotency matkets. Mol Cancer. 2007 6 12. 

Zaloudek CJ, Tavassoli FA, Norris HJ. Dysgerminoma with syncytiottophoblastic giant cells A histologically and clinically distinctive subtype of dysgerminoma. Am J Surg Pathol. 1981 5 361-367. 

Cossu-Rocca P, Zhang S, Roth LM, et al. Chromosome 12p abnormalities in dysgerminoma of the ovary A FISH analysis. Mod Pathol. 2006 19 611-615. 

Germ cell neoplasms are common in pediatric patients as well as young adults. Seminomas are occasionally found in malignant effusions in pleura, peritoneum, and hydrocele sac." Dysgerminoma is the female counterpart of the seminoma and rarely presents in effusions. These tumors can occur as pure tumors or as mixed tumors with other germ cell tumors, and they have potential to metastasize. Cell blocks have been proven to be a useful tool in the immunohistochemical studies performed to diagnose and differentiate components of mixed germ cell tumors. 

Malignant transformation (1%) usually squamous cell carci-noma (SCC) b. Dysgerminoma... 

Oct-4 S eminoma/1GC N, embryonal carcinoma Ovarian dysgerminoma, CNS germinoma Germ cells... 

Sclerosing stromal cell tumors seem to have a unique distinct centripetal contrast media uptake. Morphologically, they may resemble Krukenberg tumors or dysgerminomas. 

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