Virchows Archiv A

, Volume 407, Issue 3, pp 309–322 | Cite as

The significance of giant cells in human testicular seminomas

A clinico-pathological study
  • A. R. von Hochstetter
  • Chr Sigg
  • P. Saremaslani
  • Chr Hedinger
Article

Summary

In order to study the nature and significance of various giant cells encountered in seminomatous tumors of the testis, we reviewed the morphology of 243 consecutive pure seminomas and 107 combined (mixed) tumors, as well as the long term clinical follow-up in 26 patients. Giant cells were grouped into histocytic or neoplastic ones and the latter subtyped according to morphologic and immunocytochemical characteristics. Neoplastic giant cells were found in 34.6% of all pure seminomas and in 11.2% of all combined tumors, i.e. twice as often as histocytic giant cells in either tumor group. The various types of neoplastic giant cells were found alone or in combinations with other types. Giant cells capable of elaborating B-HCG were seen in 19.3 % of all pure seminomas and in 9.3% of seminomatous components of combined tumors. These incidences argue strongly against a trophoblastic element infiltrating a seminoma from a concomitant occult choriocarcinomatous focus. Large mononuclear giant cells, seen in spermatocytic seminomas, were observed in 15.6% of all pure seminomas, particularly in combination with B-HCG producing giant cells. Another type, characterized by marginated nuclei and eosinophilic cytoplasm were invariably part of a mononuclear cell population of similar features and encountered focally in 9.1% of all pure seminomas.

Clinical follow-up, particularly in cases with B-HCG positive giant cells, revealed that treatment as for conventional seminomas at an early stage at least is followed by an excellent course.

Key words

Seminoma Giant cells Syncytiotrophoblastic giant cell B-HCG 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Albertini Avon (1943) Zur Histogenese der Seminome. Schweiz Med Wschr 73:1091–1092Google Scholar
  2. Chevassu M (1906) Tumeurs du testicule. Thèse Faculté de Médecine de ParisGoogle Scholar
  3. Dixon FJ, Moore RA (1953) Testicular tumors. A clinicopathological study. Cancer 6:427–454Google Scholar
  4. Friedman M, Pearlman AW (1970) “Seminoma with trophocarcinoma”. A clinical variant of seminoma. Cancer 26:46–64Google Scholar
  5. Hedinger Chr, von Hochstetter AR, Egloff B (1979) Seminoma with syncytiotrophoblastic giant cells. A special form of seminoma. Virchows Arch [Pathol Anat] 383:59–67Google Scholar
  6. Hedinger Chr (1981) Atypical germ cells and germ cell tumors. Fortschr Androl 7:94–100Google Scholar
  7. Hobson BM (1965) The excretion of chorionic gonadotrophin by men with testicular tumours. Acta Endocrinol (Copenh) 49:337–348Google Scholar
  8. Hochstetter AR von, Hedinger Chr E (1982) The differential diagnosis of testicular germ cell tumors in theory and practice. A critical analysis of two major systems of classification and review of 389 cases. Virchows Arch [Pathol Anat] 396:247–277Google Scholar
  9. Javadpour N, McIntire KR, Waldmann TA (1978b) Human chorionic gonadotropin (HCG) and alpha-fetoprotein (AFP) in sera and tumor cells of patients with testicular seminoma. A prospective study. Cancer 42:2768–2772Google Scholar
  10. Kurman RJ, Scardino PT, Mclntire KR, Waldmann TA, Javadpour N (1977) Cellular localization of alpha-fetoprotein and human chorionic gonadotropin in germ cell tumors of the testis using an indirect immunoperoxidase technique. A new approach to classification utilizing tumor markers: Cancer 40:2136–2151Google Scholar
  11. Lange PH, Nochomovitz LE, Rosai J, Fraley EE, Kennedy BJ, Bosl G, Brisbane J, Catalona WJ, Cochran JS, Comisarow RH, Cummings KB, DeKernion JB, Einhorn LH, Hakala TR, Jewett M, Moore MR, Scardino PT, Streitz JM (1980) Serum alpha-feto-protein and human chorionic gonadotropin in patients with seminoma. J Urol 124:472–478Google Scholar
  12. Maier JG, Sulak MH (1973) Radiation therapy in malignant testis tumors. Part II: Carcinoma. Cancer 32:1217–1226Google Scholar
  13. Mauch P, Weichselbaum R, Botnick L (1979) The significance of positive chorionic gonadotropins in apparently pure seminoma of the testis. Int J Radiat Oncol Biol Phys 5:887–889Google Scholar
  14. Morgan DAL, Caillaud JM, Bellet D, Eschwege F (1982) Gonadotrophin-producing seminoma: A distinct category of germ cell neoplasm. Clin Radiol 33:149–153Google Scholar
  15. Mostofi FK, Price EB jr (1973) Tumors of the male genital system. Atlas of Tumor Pathology, 2nd series fasc. 8. Armed Forces Institute of Pathology, WashingtonGoogle Scholar
  16. Sigg Chr, Hedinger Chr (1983) The frequency and morphology of “giant spermatogonia” in human testis. Virchows Arch [Cell Pathol] 44:115–134Google Scholar
  17. Sternberger LA, Hardy Ph jr, Cuculis JJ, Meyer HG (1970) The unlabeled antibody enzyme method of immunohistochemistry. Preparation and properties of soluble antigen-antibody complex (horseradish peroxidase-antihorseradish peroxidase) and its use in identification of spirochetes. J Histochem Cytochem 18:315–333Google Scholar
  18. Thackray AC, Crane WAJ (1976) Seminoma. In: Pugh RCB (ed) Pathology of the testis. Blackwell Scientific Publications, Oxford, London, Edinburgh, Melbourne, pp 164-198Google Scholar
  19. Werf-Messing B van der (1971) Spread of testicular tumours. Clin Radiol 22:125–132Google Scholar
  20. Wilson JM, Woodhead DM (1972) Prognostic and therapeutic implications of urinary gonadotropin levels in the managment of testicular neoplasia. J Urol 108:754–756Google Scholar

Copyright information

© Springer-Verlag 1985

Authors and Affiliations

  • A. R. von Hochstetter
    • 1
  • Chr Sigg
    • 1
  • P. Saremaslani
    • 1
  • Chr Hedinger
    • 1
  1. 1.Institut für Pathologie der Universität ZürichZürichSwitzerland

Personalised recommendations