|I will give 2 examples of my
Testis and cord together weighing 50 gms.
The cord measures 5.5cms.
Block A = Two sections from proximal end of
Block B = 1 section from mid cord,
Block C = 1 section from cord adjacent to
The testis itself measures 5.5cm x
3.5cm x 3.0cm. The cut surface of the testis reveals a lobulated tumour mass
measuring approximately 4 cm in greatest diameter. The residual testis is
brown in colour in some areas but paler in others. The testicular mass is
adjacent to the rete testis. The tumour does not appear to have penetrated
through the the capsule.
Blocks D to J = Complete sections from the
Sections of the tumour show appearances of a
seminoma of classical pattern with mostly cohesive tumour cells with a
prominent nucleoli and delicate cytoplasm with a backround of lymphocytes
and fibrous septae.
In addition there are some areas where there
is a marked granulomatous reaction.
In a few tubules there is intra-tubular germ
Adjacent testis shows areas of atrophy with
The tumour appears confined within the
testis and no tumour is demonstrated in any of the sections in the cord.
No tumour is seen outside the capsule.
These are the appearances of a seminoma of
Summary: Seminoma -
Granulomatous reaction. Presence of intratubular germ cell neoplasia. No
tumour detected outside testis.
This is a referral case for second opinion.
A section of skin bearing a
well-circumscribed tumour. The lesion is symmetrical. This is composed of
lobules of small to medium sized germinative-type cells arranged
peripherally and differentiating into larger sebaceous cell. At the centre
of the lobules there is abundant holocrine type necrosis discharging into
sebaceous duct-like structures which communicate with surface. Mitoses are
present. There is no significant cellular atypia.
These are the appearances of a sebaceous
adenoma. Excision is complete in this section.
My opinion: The
possibility of an association with underlying visceral malignancy as part of
the Muir-Torre syndrome should always be considered in cases of Sebaceous
Adenoma. It is commonly associated with colorectal neoplasia. Rare cases of
lymphoma as part of the syndrome has also been reported.
A few selective microphotographs of seminoma
from my large collection of slides on testicular tumours.
1) Macroscopic appearance of
seminoma 2) Classical Seminoma
reaction 4) Intra-tubular germ cell neoplasia