Journal of Pathology and Translational Medicine

Original Article

Diagnostic Significance of Cellular Neuroglial Tissue in Ovarian Immature Teratoma: Yun Chai, Chang Gok Woo, Joo-Young Kim, Chong Jai Kim, Shin Kwang Khang, Jiyoon Kim, In Ah Park, Eun Na Kim, Kyu-Rae Kim; J Pathol Transl Med. 2017;51(1):49-55. Published online October 14, 2016; DOI: https://doi.org/10.4132/jptm.2016.09.19

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Background
Immature teratoma (IT) is a tumor containing immature neuroectodermal tissue, primarily in the form of neuroepithelial tubules. However, the diagnosis of tumors containing only cellular neuroglial tissue (CNT) without distinct neuroepithelial tubules is often difficult, since the histological characteristics of immature neuroectodermal tissues remain unclear. Here, we examined the significance of CNT and tried to define immature neuroectodermal tissues by comparing the histological features of neuroglial tissues between mature teratoma (MT) and IT.
Methods
The histological features of neuroglial tissue, including the cellularity, border between the neuroglial and adjacent tissues, cellular composition, mitotic index, Ki-67 proliferation rate, presence or absence of tissue necrosis, vascularity, and endothelial hyperplasia, were compared between 91 MT and 35 IT cases.
Results
CNTs with a cellularity grade of ≥ 2 were observed in 96% of IT cases and 4% of MT cases (p < .001); however, CNT with a cellularity grade of 3 in MT cases was confined to the histologically distinct granular layer of mature cerebellar tissue. Moreover, CNT in IT exhibited significantly higher rates of Ki-67 proliferation, mitoses, and necrosis than those in MT (p < .001). Furthermore, an infiltrative border of neuroglial tissue and glomeruloid endothelial hyperplasia were significantly more frequent in IT cases than in MT cases (p < .001).
Conclusions
Our results suggest that if CNT with a cellularity grade of ≥ 2 is not a component of cerebellar tissue, such cases should be diagnosed as IT containing immature neuroectodermal tissue, particularly if they exhibit an infiltrative border, mitoses, necrosis, and increased Ki-67 proliferation.

Citations

Citations to this article as recorded by

An Atypical Presentation of a Pediatric Mature Teratoma: A Case Report and Review of the Literature
Ahmed M Othman, Abdulaziz A Abu Alnasr, Reem E Kordi, Shahad A Abu Alnasr
Cureus.2024;[Epub] CrossRef
Immature Teratoma: Diagnosis and Management—A Review of the Literature
Liviu Moraru, Melinda-Ildiko Mitranovici, Diana Maria Chiorean, Marius Coroș, Raluca Moraru, Ioan Emilian Oală, Sabin Gligore Turdean
Diagnostics.2023; 13(9): 1516. CrossRef
Congenital Immature Grade ΙΙΙ Teratoma of the Neck: A Case Report
Nazneen Liaqat, Israr Ud Din, Zeeshan Ali, Majid Rashid, Afsheen Liaqat
Cureus.2023;[Epub] CrossRef
Benign ovarian teratoma in the dog with predominantly nervous tissue: A case report
P Makovicky, AV Makarevich, P Makovicky, A Seidavi, L Vannucci, K Rimarova
Veterinární medicína.2022; 67(2): 99. CrossRef
Fascin as a Useful Marker for Identifying Neural Components in Immature Teratomas of Human Ovary and Those Derived From Murine Embryonic Stem Cells
Ryunosuke Umehara, Atsushi Kurata, Masakatsu Takanashi, Hirotsugu Hashimoto, Koji Fujita, Toshitaka Nagao, Masahiko Kuroda
International Journal of Gynecological Pathology.2019; 38(4): 377. CrossRef
Cerebellar Differentiation in Ovarian Teratoma: A Report of 6 Cases
Colin J.R. Stewart, Maxine L. Crook
International Journal of Gynecological Pathology.2018; 37(4): 316. CrossRef
Mitotic activity of epithelia of ectoand entodermal types in spontaneous and experimental teratomas of mice
Pavel A. Dyban
Medical academic journal.2018; 18(4): 42. CrossRef
Ovarian cystectomy in the treatment of apparent early-stage immature teratoma
Ting Zhao, Yan Liu, Xiao Wang, Hao Zhang, Yuan Lu
Journal of International Medical Research.2017; 45(2): 771. CrossRef

Case Study

Peritoneal and Nodal Gliomatosis with Endometriosis, Accompanied with Ovarian Immature Teratoma: A Case Study and Literature Review: Na Rae Kim, Soyi Lim, Juhyeon Jeong, Hyun Yee Cho; Korean J Pathol. 2013;47(6):587-591. Published online December 24, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.6.587

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Abstract PDF

Gliomatosis peritonei (GP) indicates the peritoneal implantation of mature neuroglial tissue and is usually accompanied by ovarian mature or immature teratoma. Here, we report a case of ovarian immature teratoma associated with gliomatosis involving the peritoneum, lymph nodes and Douglas' pouch, where gliomatosis coexisted with endometriosis. As far as we know, only seven cases of GP have been reported as coexisting with endometriosis. Eight cases with mature glial tissue in the lymph nodes, i.e., nodal gliomatosis, have been published either in association with GP or in its absence. Metaplasia of pluripotent coelomic stem cells has been suggested to be responsible for the pathogenesis of endometriosis and GP rather than implantation metastases of ovarian teratomatous tumor with varying maturation. This theory is also applied to GP independently of ovarian teratomatous tumors. To the best of our knowledge, nodal gliomatosis coexisting with GP and also involving endometriosis has not yet been reported.

Citations

Citations to this article as recorded by

Mimics of primary ovarian cancer and primary peritoneal carcinomatosis – A pictorial review
B. Lawson, I. Rajendran, J. Smith, A. Shakur, V. Sadler, T.J. Sadler, H.C. Addley, S. Freeman
Clinical Radiology.2024; 79(10): 736. CrossRef
Ovarian Immature Teratoma With Nodal Gliomatosis: A Case Report and Literature Review
Marwa Alna’irat, W. Glenn McCluggage, Maysa Al-Hussaini
International Journal of Gynecological Pathology.2023; 42(6): 627. CrossRef
Germ Cell Tumors of the Ovary: A Review
Preetha Ramalingam
Seminars in Diagnostic Pathology.2023; 40(1): 22. CrossRef
Immature Teratoma with Gliomatosis Peritonei Arising in a Young Girl: Report of a Rare Case and Review of Literature
Isheeta Ahuja, Ruchi Rathore, Neerja Bhatla, Sandeep R. Mathur
Indian Journal of Gynecologic Oncology.2023;[Epub] CrossRef
Growing Teratoma Syndrome with Synchronous Gliomatosis Peritonei during Chemotherapy in Ovarian Immature Teratoma: A Case Report and Literature Review
Sijian Li, Na Su, Congwei Jia, Xinyue Zhang, Min Yin, Jiaxin Yang
Current Oncology.2022; 29(9): 6364. CrossRef
Extratesticular gliomatosis peritonei after mesenteric teratoma: a case report and literature review
Jiaqiang Li, Shoulin Li, Dong Xiao, Jiaming Song, Jianxiong Mao, Jianchun Yin
Journal of International Medical Research.2021;[Epub] CrossRef
Germ Cell Tumors of the Female Genital Tract
Elizabeth D. Euscher
Surgical Pathology Clinics.2019; 12(2): 621. CrossRef
Gliomatosis peritonei: a series of eight cases and review of the literature
Dan Wang, Cong-wei Jia, Rui-e Feng, Hong-hui Shi, Juan Sun
Journal of Ovarian Research.2016;[Epub] CrossRef

Original Article

Cytologic Features of Papillary Immature Metaplasia of Uterine Cervix.: Hye Sun Kim, Mee Im Seon, Yee Jung Kim, Hy Sook Kim; Korean J Cytopathol. 2002;13(1):21-27.

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Abstract PDF: Papillary immature metaplasia (PIM) of the uterine cervix (immature condyloma) is a subset of low grade squamous intraepithelial lesion (LSIL) which is frequently associated with human papilloma virus (HPV) types 6 and 11. The histologic features of PIM include filiform papillae lined by evenly spaced immature metaplastic-type cells with frequent nucleoli, mild anisokaryosis, and a low mitotic index. To characterize the cytologic changes associated with PIM, we analyzed 14 cases of PIM from our file. We reviewed biopsy slides and the cervicovaginal smears taken proximate to the time of biopsy. Histologically, nine cases had either flat condyloma (7 cases) or high grade squamous intraepithelial lesion (HSIL) (2 cases). Cytologic changes included cells in various stages of maturation with karyomegaly (14 cases), cells with irregularities in the nuclear membrane (13 cases), intermediate cells with karyomegaly(13 cases), cells with binucleation (13 cases), and aborted koilocytes (11 cases). Cervicovaginal smears from all cases were interpreted as atypical squamous cells of undetermined significance (ASCUS), NOS or ASCUS, rule out squamous intraepithelial lesion (SIL) or LSIL in two cases with flat condyloma or HSIL in a case with severe dysplasia. PIM is a distinct histologic entity that can present with a spectrum of cytologic findings, but cytologic findings may resemble variable reactive conditions and immature HSIL. Therefore, it is difficult to diagnose PIM by cytology alone. However, the meticulous efforts for making the cytologic diagnoses which can induce active management of patients are recommended because PIM is a variant of LSIL and frequently has a flat condyloma or HSIL.

Case Report

Low-grade Immature Teratoma of the Ovary with Gliomatosis Peritonei: A case report.: Jin Young Yoo, Sang In Shim; Korean J Pathol. 1994;28(3):322-324.

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Abstract: Immature teratoma accounts for less than I percent of all ovarian teratomas and occurs commonly in young individuals, the peak incidence being in the second decade. It contains a variable mixture of mature and immature tissues in which neuroectodermal elements almost always predominate. Gliomatosis peritonei, miliary implants of mature glial tissues on the peritoneum or omentum, is an infrequently reported complication of mature or immature ovarian teratomas. We describe the first case in Korea of a 12-year-old girl with an immature teratoma and numerous glial peritoneal implants.

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