Journal of Pathology and Translational Medicine

Case Studies

Chronic lymphocytic leukemia and concurrent seminoma in the same testis: Kosuke Miyai, Fumihisa Kumazawa, Kimiya Sato, Hitoshi Tsuda; J Pathol Transl Med. 2022;56(1):48-52. Published online October 22, 2021; DOI: https://doi.org/10.4132/jptm.2021.09.10

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Abstract PDF: A 59-year-old man presented with a painless testicular mass and underwent a radical orchiectomy. The resected specimen showed a 5-cm-sized, white-yellow and homogenous solid mass in the testicular parenchyma. Histologically, the central part of the tumor exhibited typical features of seminoma. The peripheral part of the tumor exhibited diffuse infiltration of small, monotonous lymphoid cells involving the tunica albuginea. The monotonous lymphoid cells were immunoreactive for CD20, CD79a, CD5, and CD23, and negative for CD3, CD10, and cyclin D1. Kappa light chain restriction was detected on flow cytometry using the resected specimen. Considering the circulating lymphoid cell count of >5.0×10³/µL, we diagnosed the peripheral component of the tumor as an infiltration of chronic lymphocytic leukemia. This extremely rare combination of seminoma and lymphoid neoplasm should be considered in the differential diagnosis of classic seminoma with extensive lymphoid reaction in tumors arising in elderly patients.

Mucinous Cystadenoma of the Testis: A Case Report with Immunohistochemical Findings: Gilhyang Kim, Dohee Kwon, Hee Young Na, Sehui Kim, Kyung Chul Moon; J Pathol Transl Med. 2017;51(2):180-184. Published online February 13, 2017; DOI: https://doi.org/10.4132/jptm.2016.08.30

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Mucinous cystadenoma of the testis is a very rare tumor. Herein, we report a case of mucinous cystadenoma arising in the testis of a 61-year-old man, along with a literature review. Computed tomography showed a 2.5-cm-sized poorly enhancing cystic mass. Grossly, the tumor was a unilocular cystic mass filled with mucinous material and confined to the testicular parenchyma. Histologically, the cyst had a fibrotic wall lined by mucinous columnar epithelium without atypia. Immunohistochemical staining was positive for cytokeratin 20 and CDX2, as well as focally positive for cytokeratin 7. The pathologic diagnosis was mucinous cystadenoma.

Citations

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Review of Paratesticular Appendageal Tumors, Morphology, Immunohistochemistry, and Recent Molecular Advances
Mathew Vega, Muhammad T. Idrees
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Cistoadenoma Mucinoso Paratesticular: Caso Interesante en el Instituto Guatemalteco de Seguridad Social
Edgar Estuardo González López, Carlos Gonzalo Estrada Pazos
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Yingyu Shi, Ling Song, Yan Luo
Radiology Case Reports.2023; 18(9): 3203. CrossRef
Case report: Misdiagnosis of primary mucinous cystadenoma of the testicle by ultrasound
Linlin Zhang, Jianyuan Xuan, Manxi Li, Mei Zhang, Yu Song, Ziang Pan, Bo Fan, Lin Lu, Hongyan Zhou, Yang Li
Frontiers in Oncology.2023;[Epub] CrossRef
Primary Borderline Mucinous Testicular Tumor: A Case Report and Literature Review
Changjuan Hao, Chunsong Kang, Xiaoyan Kang, Zhuanzhuan Yu, Tingting Li, Jiping Xue
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Ovarian-type Tumors (Mullerian Tumors) of the Testis: Clinicopathologic Findings with Recent Advances
Michelle S Lin, Alberto G Ayala, Jae Y Ro
annals of urologic oncology.2019; : 1. CrossRef
Borderline Mucinous Testicular Tumour: Diagnostic and Management difficulties
Krishan Pratap, Marlon Perera, Frances Malczewski, Rachel Esler
BMJ Case Reports.2018; : bcr-2017-223787. CrossRef
Mucinous tumor arising in a giant sacrococcygeal teratoma
Fengtian Zhang, Xiaolong Yu, Jin Zeng, Min Dai
Medicine.2017; 96(47): e8759. CrossRef

Well-Differentiated Papillary Mesothelioma of the Tunica Vaginalis: A Case Study and Review of the Literature: Seyda Erdogan, Arbil Acikalin, Handan Zeren, Gulfılız Gonlusen, Suzan Zorludemir, Volkan Izol; Korean J Pathol. 2014;48(3):225-228. Published online June 26, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.3.225

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Abstract PDF

Well-differentiated papillary mesothelioma is an uncommon tumor of the testes that usually presents as a hydrocele. Here, we present the case of one patient who did not have a history of asbestos exposure. The tumor was localized in the tunica vaginalis and was composed of three pedunculated masses macroscopically. Microscopically, branching papillary structures with focal coagulative necrosis were present. In addition to immunohistochemistry, simian virus 40 DNA was also tested by polymerase chain reaction. This report presents one case of this rare entity, its clinical and macroscopic features, and follow-up results.

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Testicular/paratesticular mesothelial tumours: Uncommon histopathologic entities in a very complex anatomical site
Francesca Pagliuca, Stefano Lucà, Marco De Sio, Davide Arcaniolo, Gaetano Facchini, Marco De Martino, Francesco Esposito, Ferdinando DE Vita, Paolo Chieffi, Renato Franco
Pathology - Research and Practice.2024; 253: 155069. CrossRef
Well-differentiated Papillary Mesothelial Tumour of the Tunica Vaginalis Testis – A Rare Lesion, but one Pathologists Should Know About Two Patient Reports and a Review of the Literature
Johannes Kläger, Felicitas Oberndorfer, Cristophe Brunel, Julian Veser, Eva Compérat
International Journal of Surgical Pathology.2023; 31(6): 1126. CrossRef
A diagnostic approach to paratesticular lesions with tubulopapillary architecture: a series of 16 serous borderline tumors/low-grade serous carcinoma and 14 well-differentiated papillary mesothelial tumors and mesothelioma
Rabia Zafar, Lacey J. Schrader, John C. Cheville, J. Kenneth Schoolmeester, Anja C. Roden, Marie-Christine Aubry, Eunhee S. Yi, Aditya Raghunathan, Loren Herrera-Hernandez, R. Houston Thompson, Stephen A. Boorjian, Bradley C. Leibovich, Gary L. Keeney, Ra
Human Pathology.2022; 128: 31. CrossRef
Mesothelioma subtypes of the tunica vaginalis: a rare case report and review of histological criteria
Cutts Rebecca, Martin J Connor, Luxi Sun, Thomas Johnston, Rachel Gooch, John McLoughlin
Journal of Surgical Case Reports.2019;[Epub] CrossRef
Well‐differentiated papillary mesothelioma of tunica vaginalis testis of unknown malignant potential: Sonographic appearance
K.W.S. Ko, K.S. Tse, K.W. Shek, M.N. Hau, S.H. Ting
Journal of Clinical Ultrasound.2018; 46(5): 364. CrossRef
Tunica Vaginalis Thickening, Hemorrhagic Infiltration and Inflammatory Changes in 8 Children with Primary Hydrocele; Reactive Mesothelial Hyperplasia? A Prospective Clinical Study
Ioannis Patoulias, Evangelia Rachmani, Maria Kalogirou, Kyriakos Chatzopoulos, Dimitrios Patoulias
Acta Medica (Hradec Kralove, Czech Republic).2018; 61(2): 41. CrossRef
A 45-year-old man presenting with chest pain
Sheetu Singh, Arpita Jindal
Lung India.2018; 35(2): 171. CrossRef
Two Case Reports of Benign Testicular Mesothelioma and Review of the Literature
Cristobal Ramirez Sevilla, Carme Admella Salvador, Josep Feliu Canaleta, Juan Llopis Manzanera, Miguel Angel Barranco Sanz, Juan Antoni Romero Martin, Sergi Bernal Salguero
Case Reports in Oncological Medicine.2017; 2017: 1. CrossRef
Well-differentiated Papillary Mesothelioma of the Tunica Vaginalis
Wei Keith Tan, Mae-Yen Tan, Hui Meng Tan, Rajadurai Pathmanathan, Wei Phin Tan
Urology.2016; 90: e7. CrossRef
Well-Differentiated Papillary Mesothelioma of the Tunica Vaginalis: Case Report and Systematic Review of Literature
Wei Keith Tan, Mae-Yen Tan, Wei Shen Tan, Soon Ching Gan, Rajadurai Pathmanathan, Hui Meng Tan, Wei Phin Tan
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The legacy of the F344 rat as a cancer bioassay model (a retrospective summary of three common F344 rat neoplasms)
Robert R. Maronpot, Abraham Nyska, Jennifer E. Foreman, Yuval Ramot
Critical Reviews in Toxicology.2016; 46(8): 641. CrossRef
Malignant Mesothelioma of the Tunica Vaginalis: A Rare Neoplasm—Case Report and Literature Review
Manuel Segura-González, Jorge Urias-Rocha, Jorge Castelán-Pedraza
Clinical Genitourinary Cancer.2015; 13(6): e401. CrossRef
In vivo Optical Coherence Tomography Imaging of the Mesothelium Using Developed Window Models
Yeh-Chan Ahn, Yu-Gyeong Chae, Sang Seok Hwang, Bong-Kwon Chun, Maan Hong Jung, Sung Jin Nam, Hae-Young Lee, Jae Min Chung, Chulho Oak, Eun-Kee Park
Journal of the Optical Society of Korea.2015; 19(1): 69. CrossRef

Large Cell Calcifying Sertoli Cell Tumor of the Testis: A Case Study and Review of the Literature: Dae Hyun Song, Seong Muk Jeong, Jong Tak Park, Gak Won Yun, Byoung Kwon Kim, Jong Sil Lee; Korean J Pathol. 2014;48(1):50-53. Published online February 25, 2014; DOI: https://doi.org/10.4132/KoreanJPathol.2014.48.1.50

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Abstract PDF

A 24-year-old man was admitted due to an incidentally detected mass in his left testis, which showed radiopaque calcification on plain X-ray film. Left orchiectomy was performed, and the resected testis contained a well-demarcated, hard mass measuring 1.1 cm. Histological analysis revealed that the tumor was composed of neoplastic cells, fibrotic stroma, and laminated or irregularly shaped calcific bodies. The individual cells had abundant eosinophilic or clear cytoplasm with round nuclei, each of which contained one or two conspicuous nucleoli. They were arranged in cords, trabeculae, clusters, and diffuse sheets. There were several foci of intra-tubular growth patterns, with thickening of the basal lamina. Immunohistochemically, the neoplastic cells were positive for S-100 protein and vimentin, focally positive for inhibin alpha, and negative for cytokeratin, CD10, and Melan-A. In addition to reporting this rare case, we also review the relevant literature regarding large cell calcifying Sertoli cell tumors.

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The sclerosing sertoli cell tumor of the testis: a case report
Xueyao Tang, Yifan Hu, Hong Zhou, Yang Zhou
Diagnostic Pathology.2023;[Epub] CrossRef
Large Cell Calcifying Sertoli Cell Tumor
Khaleel I. Al-Obaidy, Muhammad T. Idrees, Eman Abdulfatah, Lakshmi P. Kunju, Angela Wu, Thomas M. Ulbright
American Journal of Surgical Pathology.2022; 46(5): 688. CrossRef
Intratubular large cell hyalinizing Sertoli cell tumor of the testis presenting with prepubertal gynecomastia: a case report
Hale Tuhan, Ayhan Abaci, Banu Sarsık, Tülay Öztürk, Mustafa Olguner, Gonul Catli, Ahmet Anik, Nur Olgun, Ece Bober
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Case Report

Primary Myoepithelioma of the Testis: A Case Report.: Seong Muk Jeong, Jung Hee Lee, Won Young Park, Na Ri Shin, Woo Gyeong Kim, Gi Yeong Huh, Chang Hun Lee, Hong Koo Ha; Korean J Pathol. 2011;45:S20-S24.; DOI: https://doi.org/10.4132/KoreanJPathol.2011.45.S1.S20

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Abstract PDF

Myoepitheliomas are well-established to occur in the salivary glands, but they have also been described in the breast, upper aerodigestive tract, skin, and soft tissues. We report here on a unique case of primary myoepithelioma that occurred in the right testis of a 28-year-old man. The tumor was entirely confined to the testis and it was clearly separated from the epididymis. Histopathology revealed mixed architectural patterns in which the reticular areas merged into the chondromyxoid stroma. The tumor cells, which were focally immunoreactive to pancytokeratin and S-100 protein, were round to ovoid and spindly arranged in cords, strands, and fascicles. They showed mild nuclear pleomorphism, sparse mitotic figures and a low Ki-67 proliferative index. There was no ductal differentiation in the tumor. To the best of our knowledge, there has been only one case report of a primary testicular myoepithelioma in the English medical literature.

Citations

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Primary cutaneous myoepithelial carcinoma: a case report and review of the literature
Markus Winther Frost, Torben Steiniche, Tine Engberg Damsgaard, Lars Bjørn Stolle
APMIS.2014; 122(5): 369. CrossRef
Imprint Cytology of Soft Tissue Myoepithelioma: A Case Study
Seok Ju Park, Ae Ri Kim, Mi Jin Gu, Joon Hyuk Choi, Duk Seop Shin
Korean Journal of Pathology.2013; 47(3): 299. CrossRef

Original Article

A Serous Papillary Cystadenoma of Low Malignant Potential in Paratesticular Tissue.: Keum Min Park, Nam Bok Cho, Kye Yong Song; Korean J Pathol. 1996;30(5):463-465.

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Abstract PDF: The serous papillary cystadenoma of low malignant potential in the paratesticular tissue is a tumor characterized by its resemblance to ovarian serous papillary tumor of low malignant potential. Several possible origins have been proposed but it is thought to originate from the Mullerian-type epithelium just like ovarian serous tumor of low grade malignancy. Because of the rarity of this tumor, the natural history and treatment have not been established. Herein we report on a serous papillary cystadenoma arising in the paratesticular tissue of a 12 year old . To our knowledge, this is the first reported case in the Korean literature. The size of this cystic tumor in this patient was 0.9x0.9x0.8 cm and had a sponge-like cut surface. The papillary structure was lined by both ciliated and nonciliated secretory cells, the same cellular structure as the salpinx. Areas with just a few mitoses and stratification of epithelial cells were noted, but invasion into the paratesticular tissue was absent, suggesting borderline malignancy. He is doing well after 5 months follow up. Prognosis of this scrotal tumor is thought to be better than the ovarian tumor of similar histology due to a better possibility of early detection.

Case Reports

Juvenile Granulosa Cell Tumor Arising in Undescended Testis: A case report.: So Ya Paik, Hae Youn Kang, Jae Ho Han, Woo Ick Yang, Seok Joo Han; Korean J Pathol. 1999;33(5):376-379.

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Abstract PDF: Juvenile granulosa cell tumor is rare but one of the common congenital testicular neoplasms. Although histological features are typical of its ovarian counterpart, testicular juvenile granulosa cell tumor has a distinctly different clinical presentation. We report a case of juvenile granulosa cell tumor arising in the cryptochid testis of a 4-day-old newborn. A 6 5 5 cm sized multilocular cyst containing thick, mucinous fluid was found in the peritoneal cavity. The external surface of the cyst was smooth and the septae were relatively thin. The cyst consisted of numerous mucin-filled, cystic follicles lined by cells having vacuolated cytoplasm and round to oval dark nuclei without grooves. Cells resembling granulosa cells of an ovarian follicle were also observed in the intervening stroma forming irregular solid nests.

Primary Carcinoid Tumor Arising in a Mature Teratoma of the Testis: A Case Report.: Jai Hyang Go; Korean J Pathol. 2001;35(1):86-88.

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Abstract PDF: Primary carcinoid tumor is rarely associated with mature teratoma in the testis. In the few cases reported, the primary carcinoid tumors in the testis were often microscopic in size. Although it has been generally accepted that carcinoids arising in teratomas have an indolent clinical course, some of these tumors have been reported to metastasize and cause death of the patient. Therefore, long term follow up may be warranted for patients having primary testicular carcinoid tumors irrespective of coexisting teratoma. We report a case of primary testicular carcinoid tumor of microscopic size incidentally found in mature cystic teratoma occurring in a 44 year-old male patient.

Diffuse Embryoma of the Testis: A Case Report.: Won Ae Lee; Korean J Pathol. 2008;42(2):103-107.

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Abstract PDF: Diffuse embryoma of the testis is a very rare, distinct form of mixed germ cell tumor. I report here on a case of diffuse embryoma in a 22-year-old male who presented with painful scrotal swelling. The resected testis was entirely occupied by a non-encapsulated tumor mass. The cut surface of the tumor was grey or whitish pink, soft and granular with foci of hemorrhage and necrosis. Microscopically, the tumor was characterized by a diffuse, orderly arrangement of embryonal carcinoma and yolk sac tumor in almost equal proportions. The yolk sac tumor component was diffusely wrapped around the embryonal carcinoma. Syncytiotrophoblasts were scattered throughout the tumor. Minor foci of immature teratoma, seminoma and intratubular germ cell neoplasia were observed. The yolk sac tumor (YST) component was emphasized by immunoreactivity for alpha fetoprotein, whereas the embryonal carcinoma was reactive for CD30. The strong reactivity for cytokeratin in the YST component formed an outstanding contrast to the weak cytokeratin reactivity in the embryonal carcinoma.

Actinomycosis of the Penile Shaft Coexisting with Fibrous Pseudotumor of the Testis.: Eun Jung Cha, Kyu Yun Jang, Ho Sung Park, Jong Kwan Park, Chang Seop Lee, Myoung Ja Chung, Woo Sung Moon, Dong Geun Lee, Myoung Jae Kang; Korean J Pathol. 2008;42(1):50-53.

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Abstract PDF: Here, we present an uncommon case of the penile shaft actinomycosis with coexisting fibrous pseudotumors of the testis. A 37-year-old, circumcised man presented with one penile and eight scrotal masses. The penile mass having a healed surface ulceration was located at the right side of the penile shaft. It was relatively circumscribed without a fibrous capsule. The cut surface showed a yellow-brown color with central focal necrosis. The scrotal tumors were circumscribed, whorled, white masses 0.3-2.0 cm in diameters, and were attached to the tunica vaginalis and tunica albuginea. Microscopically, the penile mass showed active inflammatory changes containing actinomyces displaying characteristic sulfur granules. Testicular masses were fibrous pseudotumors composed of bland spindle and stellate cells lying in dense collagenous stroma. Actinomycosis of the penis has been reported to occur at the corona of the uncircumcised penis associated with pilonidal sinus. The present case was not associated with pilonidal sinus and, unusually, displayed co-existence with fibrous pseudotumors of the testis.

Enterogenous Cyst of the Testis.: Sang Chul Nam, Man Hoon Han, Seok Jun Ye, Tae Gyun Kwon, Bup Wan Kim, Ghil Suk Yoon; Korean J Pathol. 2007;41(4):271-273.

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Abstract PDF: We present a rare case of an enterogenous cyst of the testis in a 21-year-old man. On ultrasonography, an ovoid hypoechoic solid mass (2x2x1.5 cm) was confined to the right testis. The left testis and bilateral epididymis were within normal limits. Grossly, the tumor was a unilocular cystic mass, without a solid component. Microscopically, the cystic mass was composed of mucin-secreting simple columnar epithelial lining cells, lamina propria and a well-differentiated muscularis propria. There was no evidence of any germ cell derivatives or neoplasia in the cystic mass and in the surrounding testicular parenchyma. Immunohistochemistry showed a positive reaction for cytokeratin and the epithelial membrane antigen in the epithelial lining; in addition, it was positive for smooth muscle actin in the well-differentiated muscularis propria.

Paratesticular Papillary Serous Tumor of Low Malignant Potential: A Case Report.: Moon Il Park, Hun Soo Kim, Kwang Sun Suh, Dae Young Kang; Korean J Pathol. 2004;38(6):427-429.

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Abstract PDF: Paratesticular papillary serous tumors have been rarely reported, and they often resemble ovarian serous tumors of borderline malignancy. We experienced a case of papillary serous tumor in the left paratestis of a 39-year-old man. This is the second case reported in the Korean literature. The tumor, which was found incidentally during an operation for a hydrocele, was composed of papillary structures lined by cuboidal to columnar epithelial cells that displayed low cytologic atypia and frequent psammoma bodies.

Original Article

The Apoptotic Molecular Changes of Cellular Injury in Mouse Testis Induced by Endocrine Disrupting Chemicals.: Eun Hui Wang, Kweon Heang Lee, Ki Hwa Yang, Jinsuk Lee, Eun Sun Jung, Chang Suk Kang, Yeong Jin Choi; Korean J Pathol. 2004;38(4):228-237.

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Abstract PDF: BACKGROUND
Spermatogenesis is regulated by various cellular reactions, and especially cell proliferation and apoptosis.
METHODS
We investigated the morphological changes and the apoptotic molecular changes in mouse testis induced by the endocrine disrupting chemicals. ICR mice were treated with bisphenol A (BPA), 2-bromopropane (2-BP) and diethylstilbesterol (DES). Histological examination and immunohistochemical staining, TUNNEL staining and RNAse protection assay were conducted.
RESULTS
Testes treated with BPA showed normal spermatogenesis and the proliferation activity, and the density of the cells was similar with those in the control. 2-BP and DES groups, which showed a decrease of germ cells near the basal layer and degenerative changes. The proliferative activity identified by PCNA staining was significantly decreased in the 2-BP and DES groups (p<0.05). The apoptosis was significantly increased in the 2-BP group however, a significant decrease was noted in the BPA group (p<0.05). Among apoptosis-related molecules, the expression of Fas, Fas ligand, TRAIL, TNFp55 and caspase 1, 3, 6 and 8 were changed according to the change of the degree of apoptosis in all groups.
CONCLUSIONS
Endocrine disrupting chemicals induced cellular injury in mouse testis through the changes of proliferative activity and apoptosis which was regulated by a number of apoptosis-related molecules. This probably results in the abnormality of spermatogenesis in mouse testis.

Case Report

Primary Carcinoid Tumor of the Testis: A case report.: Yikyeong Chun, Yeon Lim Suh; Korean J Pathol. 1995;29(2):228-231.

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Abstract PDF: Primary carcinoid tumors of the testis are exceedingly rare. They may originate as a pure form or as part of a testicular teratoma. To diagnose a testicular tumor as primary carcinoid, the possibility of metastasig must be carefully excluded. To our knowlege, none has been reported in Korean literature. We present a case of primary testicular carcinoid in a 36-year-old man. He had a painless, palpable mass on the right scrotum for 4 years. He underwent a radical orchiectomy. He is free of disease during 20 months postoperatively. Histologically and ultrastructurally this tumor showed a typical feature of carcinoid tumor of midgut derivation. A flow cytometric DNA analysis of this mass contained an aneuploid cell population.

Original Article

Metastatic Embryonal Carcinoma of Testis: Aspiration Cytology of Cervical Lymph Node.: Jung Weon Shim, Hae Kyung Ahn, Il Hyang Ko; Korean J Pathol. 1990;24(1):91-94.

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Abstract PDF: Embryonal carcinoma of testis may be composed of primitive cells with epithelial appearance showing prominent variation in size and shape, clear cytoplasm, overlapping nuclei. and many mitoses. Multiple lymph node enlargement was noticed in a 45-year-old man with known huge testicular tumor, 20 x 15 cm, and clinically malignant lymphoma was suspected. Microscopic and cytologic finding of both biopsy and needle aspiration from neck lymph node disclosed highly undifferentiated large cells, mostly in solid sheets and often forming glandular spaces. Massive necrosis was observed. Cytologic diagnosis of embryonal carcinoma was made possible, relied on the result of immunohistochemistry that revealed negative LCA, and positive cytokeratin and CEA as well as the cytologic features. Serum levels of HCG and AFP of the patient, in addition, were markedly elevated.

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