Elsevier Pathology

Anatomic Pathology: Gynecologic Pathology

Back
526) An 18-year-old woman recently underwent left oophorectomy. The histologic finding of one component of the tumor is shown. You would expect all of the following immunohistochemical markers to be positive in this lesion EXCEPT:

• Embryonal carcinomas are composed histologically of disorganized sheets of large primitive cells that may form papillae. The nuclei often contain large, prominent nucleoli. Mitotic activity is brisk, and necrosis is commonly seen.

• Embryonal carcinoma as a pure ovarian neoplasm is rare. It is more commonly seen as a component of mixed germ cell tumor.

• OCT 4 is a transcription factor that regulates and maintains pluripotency in embryonic germ and stem cells. It is highly sensitive and specific for embryonal carcinoma as well as dysgerminoma/seminoma. It has a nuclear immunohistochemical staining pattern.

• CD30 staining is common in embryonal carcinoma, although it should not be used as the sole diagnostic marker. It has a membranous staining pattern.

• Most embryonal carcinomas demonstrate positivity for CD30, OCT 4, cytokeratin AE1/AE3, and AFP. Cytokeratin 117, epithelial membrane antigen (EMA), and CD45 are consistently negative.

Baker PM, Oliva E: Immunohistochemistry as a tool in the differential diagnosis of ovarian tumors: an update. Int J Gynecol Pathol 2004;24(1):39-55.

Ulbright TM: Germ cell tumors of the gonads: a selective review emphasizing problems in differential diagnosis, newly appreciated, and controversial issues. Mod Pathol 2005;18(Suppl 2):S61-S79.

Back
 
* = Required 
* Note Title
* Note
Save Cancel