Ultrastructure of a virilizing ovarian sertoli-leydig cell. Tumor with familial incidence

Hormone-producing tumors of the ovary

The ovary is an endocrine organ that gives rise to a wide variety of neoplastic and tumorlike nonneoplastic conditions, some of which are associated with endocrine activity. The hormones produced may be steroidal or nonsteroidal. The ovary is unique among endocrine organs in reacting to the presence of nonendocrine tumors within it by abnormal or inappropriate production of sex steroidal hormones. A classification of hormone-producing ovarian lesions is proposed based on the World Health Organization's histologicai typing of ovarian tumors.

Morphology of canine ovarian Sertoli-Leydig cell neoplasms. A report of 12 cases

Of 71 dogs with primary ovarian neoplasms, 12 (17%) had Sertoli-Leydig cell tumors. Five dogs had Sertoli-Leydig cell tumors, four had pure Sertoli cell tumors, and three had Sertoli-Leydig cell tumors with a retiform pattern. Variously differentiated Sertoli cells were seen in the Sertoli-Leydig cell tumors, and one of these metastasized to the peritoneum. The pure Sertoli cell tumors were similar to these tumors in male dogs. The retiform pattern in the third group of tumors was characterized by tubuloalveolar structures resembling rete testes. Heterologous elements were seen in seven tumors (58%)--enteric glands in three Sertoli-Leydig cell tumors and one Sertoli-Leydig cell tumor with retiform pattern, and neuroendocrine carcinoma in one pure Sertoli cell tumor and two Sertoli-Leydig cell tumors with retiform pattern. The uterus was examined in seven dogs, and six (87%) had endometrial hyperplasia.

Cellular junctions in a spectrum of human malignant tumors

Cellular junctions in tumors are often considered a hallmark of epithelial differentiation. However, junctions are also seen in tumors having a different differentiation. This observation prompted us to study cellular junctions in malignant nonepithelial tumors. We found a variety of cellular junctions in such tumors, although the majority were poorly formed. This observation is of importance for diagnostic purposes. We have also tried to clarify the nomenclature of cellular junctions as applied in tumor diagnosis by proposing a systematic categorization of terms in everyday use by pathologists and by referring more extensively to the term paired subplasmalemmal densities (PSD) for non-well-formed junctions.

Detection of human papillomavirus DNA in advanced epithelial ovarian carcinoma

Tissue specimens from 10 out of 12 patients with advanced epithelial ovarian adenocarcinoma contained DNA of human papillomavirus type 6 (HPV-6). HPV DNA was identified by in situ hybridization at high stringency using biotin-labeled DNA probes. Nonneoplastic tissue specimens from other pelvic sites of the same patients were also examined. None showed evidence of HPV DNA. The meaning of these findings in relation to epithelial ovarian carcinoma is discussed.

Sex cord-stromal tumours of the ovary

The aim of this review is to give a reasonably concise resumé of our knowledge of the sex cord-stromal tumours of the ovary. Lipoid cell tumours of the ovary are often included within this broad category but this poorly defined and heterogenous group of neoplasms will not be considered here. This review is a selective one and no attempt is made to cover all aspects of sex cord-stromal tumours or to provide a complete bibliography. The histological features of many of the neoplasms in this group, particularly those which have been recently defined, are discussed but a consideration of differential histological diagnosis is excluded. The ultrastructural characteristics of the various neoplasms are considered only in terms of their relevance to histogenesis or metabolic activity.

Ovarian androblastoma metastatic to tonsil

Structural pattern of a tonsillar tumor found in a 67-year-old female was similar to a small ovarian androblastoma diagnosed histologically 6 1/2 years earlier. Electron microscopic study of the tonsillar mass revealed crystalloid structures suggestive of the Leydig cell origin of the tumor. After tonsillectomy, there was no local recurrence of the tumor, but the patient died a year later of multiple metastases. There appeared to be no previous reports of ovarian tumors metastatic to tonsil, and malignant androblastomas of the Leydig cell type are extremely rare.

Large cell calcifying Sertoli tumor of the testis. Light microscopic and ultrastructural study

Large cell calcifying Sertoli tumor of the testis was found in a 16-year-old boy who had presented with gynecomastia. Serum estrogen level, which had been elevated preoperatively, returned to normal following orchiectomy. Charcot-Bottcher crystalloids are demonstrated in the neoplastic Sertoli cells.

Histogenesis, cytodifferentiation, and its subcellular steroidogenic sites in the virilizing ovarian Leydig cell tumor: light microscopic dry-mounting radioautography for [3H]cholesterol and electron microscopic cytochemistry for 3 beta-hydroxysteroid dehydrogenase activity

A case of a virilizing ovarian Leydig cell tumor in a 38-year-old woman with a marked elevated plasma testosterone level was investigated using light microscopic dry-mounting radioautography and electron microscopic cytochemistry. Following a total abdominal hysterectomy and bilateral salpingo-oophorectomy, the plasma testosterone level decreased abruptly. Light microscopic dry-mounting radioautography for [3H]cholesterol showed silver grains localized mainly over the cytoplasm of the neoplastic Leydig cells which were of three different cell types: fibroblast-like cells, Leydig cells (steroid-secreting cells), and transitional cells (partially or incompletely differentiated Leydig cells). Reaction products for 3 beta-hydroxysteroid dehydrogenase activity were localized on the tubular or lamellar cristae and inner membranes of the mitochondria, and on the membranes of smooth endoplasmic reticulum in the transitional cell as well as in the Leydig cell. From these observations, it is suggested that the Leydig cell tumor is derived from the fibroblast-like cell and from the transitional cell, morphologically falling between the fibroblast-like cell and the Leydig cell, has fine structural evidence of steroidogenic activity, and has an ability to secrete testosterone.

Sclerosing stromal tumor of the ovary. A hormonal, histochemical and ultrastructural study

Three new cases of sclerosing stromal tumor of the ovary have been studied by hormonal, immunohistochemical and electron microscopic analysis. The results confirm that this tumor may have hormonal activity. Ultrastructural study shows findings different from those previously reported. The authors propose an origin from the ovarian stroma with luteinization of stromal tumor cells.

Ovarian Sertoli-Leydig cell tumor with rhabdomyosarcoma: an ultrastructural study

The clinical and light and electron microscopic findings of a moderately differentiated, virilizing, Sertoli-Leydig cell tumor (SLT) with pleomorphic rhabdomyosarcoma of the ovary are presented. The tumor recapitulates the primitive embryonal testis and rhabdomyogenesis, respectively. The natural history, including pathogenesis, of this peculiar and rare tumor is discussed in the light of the pertinent literature on SLT and ovarian rhabdomyosarcoma. It seems that when rhabdomyosarcoma is a significant or predominant component of SLT, as occurred in this case, the prognosis is poor and is that of rhabdomyosarcoma in general.

Ultrastructure of a virilizing ovarian Leydig-cell-tumor. Hilar cell tumor

A case of virilizing ovarian hilus cell tumor (Leydig-cell tumor) in a 37 year old female was studied by light and electron microscopy. The ultrastructural features of this rare and almost always benign tumor are compared with those reported in the literature and with findings in normal and neoplastic interstitial cells of the testis. Tubulovesicular hyperplasia and formation of whorl structures of the endoplasmatic reticulum together with the presence of exocytosis vesicles on the cell surface may be the morphological manifestation of endocrine activity of the tumor. The identity of ultrastructural and optical diffraction characteristics of the crystal inclusions in both cells (hilar and testicular interstitial) favours the assumption of an homology of both cells and their neoplasms.

Gynandroblastoma: its ultrastructure

Gynandroblastoma is a rare, sex-cord stromal tumor of the ovary that shows morphologic evidence of female and male differentiation. Such a tumor produced masculinization in a 24-year-old woman, whose symptoms disappeared following removal of the tumor. By electron microscopy, the granulosa cell nests displayed Call-Exner (CE) bodies of the hyaline type composed of multiple layers of basal lamina resembling CE bodies of the normal graafian follicle. In contrast, CE bodies of a classic granulosa theca cell tumor were of the spongiform type, consisting of a space limited by a single basal lamina containing altered granulosa cells and cell processes. Both types of CE bodies are believed to arise following secretion by and/or degeneration of granulosa cells, the variation in morphology between the two resulting from differences in amounts of basal lamina deposited. The tubular components of the tumor resembled more closely the rete ovarii than did Sertoli cells, and its proposed that such structures be called by the alternate and less specific term "androblastoma." The identity of Leydig cells was established by demonstrated of intracytoplasmic Reinke crystals. Despite a difference in architectural pattern, there was a close ultrastructural resemblance between the different sex-cord components of the gynandroblastoma.

Cancers of the breast and female genital system: search for recessive genetic factors through analysis of human isolate

To investigate the importance of recessive genes in female breast and genital cancers, we have conducted investigations in the Hutterites, a highly inbred genetic isolate in North America. The homogeneous life style of this group, which lives on communal farms, also facilitates distinction between shared environmental and genetic factors. We ascertained 177 cases of cancer (all organ systems) through Canadian and United States cancer registries, field trips, and searches of death certificates. Breast cancer and endometrial cancer mortalities were those expected for 1970 United States whites, but no deaths due to squamous cervical carcinoma were ascertained in this monogamous population. Inbreeding coefficients (F) for cases were higher than means for matched controls for each of the four cases of breast cancers that occurred in younger women (less than 45 years of age), for four of five cases of endometrial cancer, and for the single cases of uterine leiomyosarcoma, dysgerminoma, and ovarian adenocarcinoma. By contrast, in cases of breast cancer that occurred in women 45 years of age or older, only four of 15 F's were above those for controls. There is a significant difference between the two breast cancer age groups with respect to the likelihood that the F of cases was higher than the F of controls (chi 2 = 6.99, p less than 0.01). However, grouping cases by type, none of the F distributions were significantly different from those of their matched controls. These preliminary genetic investigations thus conform certain concepts concerning breast and female genital cancer but also suggest the desirability of further studies to elucidate the role of genetic factors in premenopausal breast cancer.

Sertoli tumors of the ovary. A clinicopathologic study of 28 cases with ultrastructural observations

The clinical and pathologic features of 28 Sertoli tumors of the ovary are presented. Seventeen of the 18 neoplasms had a functional effect. The effects were hyperestrinism (eight women), isosexual precocious puberty (three girls), virilization (four women), a progestational decidual reaction on the peritoneum (one woman), and a combination of virilizing and estrinizing signs (one woman). There were three histologic patterns: simple tubular, complex tubular, and folliculome lipidique. Two neoplasms recurred, both of which had the distinctive feature of invasion of the supporting stroma by individual and columns of tumor cells in the original tumors. Electron microscopic evaluation of three neoplasms disclosed. Charcot-Böttcher filaments unequivocally identifying the Sertoli differentiation of the predominant cells in the neoplasm. The identification by electron microscopy of a smaller population of cells within the three tumors similar to typical ovarian stromal cells suggests that Sertoli tumors arise from ovarian stromal cells.

Ovarian Sertoli-Leydig cell tumors. A clinical, pathological and ultrastructural study with particular reference to the histogenesis of these tumors

Ovarian Sertoli-Leydig cell tumors are rare, most of them being endocrinologically active and causing virilization. Their histogenesis and nomenclature are still under discussion. Six such tumors were identified in the Laboratory for Histopathology of the University Women's Hospital, Zürich. The clinical data as well as the macroscopic, microscopic and ultrastructural features of these tumors are analysed and discussed. In an attempt to clarify their histogenesis, the ultrastructural features of these tumors have been compared with those of two granulosa cell tumors as well as with those of a testis in a patient with testicular feminization. Our own results and a study of published data suggest that Sertoli-Leydig cell tumors arise from ovarian stroma. Because of their obvious morphological similarities to testicular structures they should be termed "gonadal stromal tumors of android type".

Stromomyoma of the uterus

We present a solitary uterine tumor that occurred in a 28-year-old woman who complained of vaginal bleeding. Grossly, the tumor was well circumscribed and composed of lobulated tissue that varied from yellow, tan and soft, to white and rubbery. At the light microscopic level, areas identical to those described and interpreted as sex-cord differentiation in a group of closely similar uterine tumors were found and obtained for electron microscopic study. Ultrastructurally, there were two basic types of cells, neither of which can be interpreted as sex-cord derivatives. Cells that closely resembled the predominant components of Clement and Scully's group I tumors were similar to the normal endometrial stromal cells. Cells that formed plexiform cords demonstrated features diagnostic of smooth muscle cells. Cellular contents in cells comprising the tubular structures resembling that interpreted as indistinguishable from that of a Sertoli-cell tumor (tubular androblastoma) were probably smooth muscle cells. We propose the term "Stromomyoma" to designate this peculiar uterine tumor. The similarity between our tumor and those reported in the literature raises the possibility that "uterine tumor resembling" ovarian sex-cord tumors" are actually stromomyomas.

Sertoli cell tumors of ovary: light microscopic and ultrastructural study with histogenetic considerations

Two cases of pure Sertoli cell tumors of the ovary are presented. The tumors were grey to brown and generally solid, but with several cystic areas. They showed a highly differentiated, but variable, histologic patterns with solid cords of neoplastic cells, as well as tubular formations. Ultrastructurally, the basal part of the cells rested on a nonfibrillary basement membrane layer while the free border showed occasional cilia. Laterally, the cells showed tight junctions and desmosomes. Abundant rough endoplasmic reticulum and some cystically dilated smooth endoplasmic reticulum were evident. The theories regarding the histogenesis are discussed. Enough similarities, both by light and by electron microscopy, are presented between these tumors and the Sertoli cell to justify classifying these ovarian tumors as Sertoli cell in type. The development of cilia is considered to be a manifestation of focal metaplasia of the neoplastic Sertoli cell.

The ultrastructural morphology of gynecologic neoplasms

Our knowledge of the morphology and pathogenesis of malignant neoplasms of the female genital tract has traditionally depended heavily on their light microscopic characteristics. The introduction of transmission, and most recently, scanning electron microscopy, into the field of gynecologic pathology has resulted in a considerable improvement in the diagnosis of genital cancers that are difficult to classify and has provided valuable information for a better understanding of their subcellular dynamics and pathogenetic development. This paper describes and illustrates the ultrastructural alterations that are considered specific for the most common malignant and potentially malignant neoplasms of the genital system in this context. The value of electron microscopy in the morphologic study of genital cancers warrants its increased use in routine diagnostic pathology, as well as further evaluation of it in basic research in this challenging area of investigation.