The ultrastructure of gonadoblastoma and dysgerminoma

Dysgerminoma in an Arabian filly

A yearling Arabian filly was referred to the Veterinary Medical Teaching Hospital with a history of weight loss, profound anemia, and peritoneal effusion. At necropsy, a large, soft, mottled tan and red neoplastic mass was at the pelvic inlet replacing the left ovary. Additional tumor nodules of various sizes were disseminated throughout the mesentery, diaphragm, and serosal surfaces of the abdominal viscera. Histologically, the neoplasm had sheets of large round to polygonal cells separated into lobules by fibrous connective tissue with multifocal areas of necrosis. Tumor cells stained strongly for alkaline phosphatase. Immunohistochemically, tumor cells expressed vimentin and were negative for cytokeratin. Ultrastructurally, the neoplastic cells had a characteristic nucleolus with an elaborate reticular nucleolonema in an irregular configuration. This is the first in-depth detailed report of this very rare germ cell tumor of the ovary in horses.

Fine-needle aspiration biopsy of seminoma and dysgerminoma: cytologic, histologic, and electron microscopic correlations

Cytomorphologic features in a series of fine-needle aspiration biopsies from eight patients with seminoma or dysgerminoma were reviewed, and the findings were further correlated with histopathologic and ultrastructural appearances. Three cell types were encountered. Type I was least differentiated and least frequent. Type II was most frequent and had well-developed cytoplasm rich in organelles. Type III was similar to type II but also contained abundant cytoplasmic glycogen. In cytology smears, type III cells contained large punched-out cytoplasmic vacuoles corresponding to the areas of glycogen deposition. The background contained a variable mixture of inflammatory cells including lymphocytes, plasma cells, epithelioid cells, and epithelioid granulomas. The significance of these findings in the diagnosis of seminoma or dysgerminoma and the distinction from other germ-cell and non-germ-cell tumors is briefly discussed.

Ovarian gonadoblastoma with dysgerminoma in a woman with two normal children

An unusually rare case of unilateral gonadoblastoma with dysgerminoma occurring in the ovary of a 28-year-old woman with two normal children is reported.

Electron microscopy applied to fine-needle aspiration. A report of six cases from various sites

The authors report the results obtained from the application of electron microscopy techniques to the cytology of fine-needle-aspirated samples of neoplastic lesions from various body sites. These results show that the tissue structure, which is usually lost during the squashing necessary for light microscopy cytology, is preserved when the samples are processed for ultrastructural analysis. Electron microscopy also allows a highly detailed study of the cell's inner structures. Thus, when this technique is applied, fine needle-aspirated samples can be regarded as actual microbiopsies. However, because of the high cost of ultrastructural techniques, we suggest that actual analysis be performed only in selected cases, whereas fixation and inclusion for electron microscopy could be done routinely.

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.

An ultrastructural study on germinoma cells

Germinoma cells were ultrastructurally studied in 17 cases composed of 8 cases with testicular seminoma, 3 cases with ovarian dysgerminoma, 4 cases with intracranial germinoma and one case with mediastinal germinoma. The tumor cells were generally polyhedral in shape, and has frequently a cytoplasmic process, occasionally a long process like a pseudopod. Regarding several components of the cytoplasm, most of the tumor cells in all but few cases had varying numbers of glycogen granules and fatty droplets, some of tumor cells in all but few cases had annulate lamellae, junctional apparatuses and microvilli, while stacks of rER or large autolysomes were observed in some of the tumor cells in several cases. In some of the seminoma cells and dysgerminoma cells observed were one or more of 4 types of intranuclear pseudoinclusions. Definite differences among germinoma cells associated with their originating sites were not recognized except for a few features of the nucleus.

The coexistence of ribosome-lamella complex and annulate lamellae in chronic lymphocytic leukemia

An electron microscopic study of peripheral blood and lymph node from a patient with chronic lymphocytic leukemia revealed ribosome-lamella complexes in 11-16% of the peripheral lymphocytes and in 14% of the nodal lymphocytes. Annulate lamellae were seen in 2-8% of the peripheral lymphocytes and in 8% of the nodal lymphocytes. One peripheral blood specimen revealed coexistence annulate lamellae and ribosome-lamella complexes within the same cells in an additional 4% of the lymphocytes. The two structures were connected by continuous strands of apparent endoplasmic reticulum. Although annulate lamellae and ribosome-lamella complex have each been described in chronic lymphocytic leukemia, albeit uncommonly, their unusual association with one another has not previously been documented and might offer a clue as to the origin and role of these interesting structure. The possible ramifications of these observations include relationship of the structures to endoplasmic reticulum and protein synthesis, to in vitro and possible clinical induction by drugs including "antitubulins," and to induction in vitro by viral infection.

Microscopic gonadoblastoma in dysgenetic gonad of an infant: an ultrastructural study

A microscopic gonadoblastoma found in the dysgenetic gonad of a six-month-old phenotypic female with a 46,XY genotype was studied with the electron microscope and compared with the cells from the testicular portion of the contralateral gonad. The germ cells within the tumor resembled the testicular germ cells and were not different from previously described germ cells in other gonadoblastomas of postpubertal patients. The sex cord cells of the present tumor were inactive and immature, but differed from the Sertoli cells of the patient's testis. The presence of hyalin globules and Call-Exner bodies in the epithelial tumor nests, coupled with the ultrastructural appearance of the sex cord cells is more consistent with them being immature granulosa rather than Sertoli cells. The immaturity of the sex cord cells in gonadoblastoma of this infant suggest that they are responsive to normal regulatory hormonal influences.

Pathological survey of intracranial germinoma and pinealoma in Japan

Pathologic survey was performed on 43 cases of intracranial germinoma and 12 cases of pinealoma. The present study suggests that, in Japan, the incidence of teratoma groups including germinoma is remarkably higher than that in U.S. and Europe, whereas the rate of true pinealoma is lower. Using ultrastructural, enzyme-histochemical, and fluorescence-histochemical methods for a few surgical specimens, a strong similarity between intracranial germinoma (so-called "pinealoma" with a two-cell pattern) and seminoma and dysgerminoma was confirmed. The true pinealoma could be classified as pineoblastoma and pineocytoma, according to the degree of pineocyte differentiation of the tumor cells, and as "neuroblastoma-like" and "pineal-like" on the basis of the histologic architecture.

Anaplastic seminoma of the testis: ultrastructural analysis of three cases

Three anaplastic seminomas of the testis were examined by transmission electron microscopy, and the ultrastructural features are described for comparison with those reported in other seminomas and related neoplasms. It is concluded that anaplastic seminomas are similar ultrastructurally to classic testicular seminomas, extragondal seminomas, and ovarian dysgerminomas, all of which are less differentiated than spermatocytic seminomas.

Ultrastructure of gonadoblastoma and disgerminoma (seminoma) in a patient with XY gonadal dysgenesis

The gross and fine morphology of gonadoblastoma and disgerminoma in a young phenotypic female with male karyotype and gonadal dysgenesis is described. Both the rudimentary gonads contain gonadoblastomas on the left side in association with a disgerminoma. In the light microscope the gonadoblastomas show peculiar hyaline masses, surrounded by Sertoli-like cells. In some areas a direct continuation between hyaline masses and basement membranes of round nests or large anomalous seminiferous tubules is obvious. At the ultrastructural level the hyaline masses consist of densely packed, largely concentric membranes closely similar to basement membranes or basal laminae of seminiferous tubules. These observations and the finding of transitional zones with gonadoblastoma elements in enlarged tubular structures suggest that gonadoblastomas originate inside tubules of dysgenetic testes. The peculiar hyaline masses with their concentric membranes might reflect hyperplasia and death of the Sertoli cells, each new generation of cells producing a basement membrane outside the preceding one.

Malignant germ cell tumors of the ovary

This article reviews 281 malignant germ cell tumors of the ovary from the Armed Forces Institute of Pathology and highlights their distinctive clinical and pathologic features. Emphasis is placed on the importance of a combined therapeutic approach utilizing surgery, chemotherapy, and radiation. The rationale for unilateral salpingo-oophorectomy in conjunction with chemotherapy for certain types of neoplasm confined to one ovary (stage 1a) is emphasized, and the role of human chorionic gonadotropin and alpha-fetoprotein as tumor markers in the management of patients with these tumors is discussed.

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.

Gonadoblastoma: histologic, ultrastructural, and histochemical observations in five cases

In this series of gonadoblastomas it appeared that the germ cells were the motivating force underlying either tumor proliferation or regression. The ultrastructural morphology confirmed the presence of undifferentiated gonadal cells with active steroid synthesis by the interstitial cells. The Call-Exner-like bodies which showed extensive calcification were composed of basement membrane material containing a sulfated mucosubstance. A histochemical comparison with the noncalcifying Call-Exner bodies of a granulosa-cell tumor differed only in their glycoprotein content. The calcium deposits were identified as oriented hydroxyapatite crystals by electron diffraction, and it is proposed that the basement membrane material serves as a nucleation site for calcification. High serum testosterone levels were correlated with the presence solely of interstitial cells in one case. The finding of a gonadoblastoma without the presence of a Y chromosome contradicts earlier proposals concerning the requirement of a Y chromosome for germ cell proliferation.

Gonadoblastoma: ultrastructural evidence for testicular origin

A gonadoblastoma arising in the dysgenetic gonad of a virilized 17-year-old Caucasian with a female phenotype and with a 45,X0/46, X-ring-Y genotype was studied by light microscopic histochemistry, electron microscopy, and ultrastructural histochemistry. The gonadoblastoma was composed of nests of cells containg large germ cells and small "granulosa-Sertoli-like cells," and stromal tissue containing "Leydig-like cells." The germ cells were identical to those found in normal fetal gonads and in germ cell tumors. Charcot-Böttcher crystalloids present in the "granulosa-Sertoli-like cells" strongly suggest that they are, in fact, Sertoli cells. Multilayered basal laminae located in the periphery of the tumor nests and in "hyaline bodies" were identical to those surrounding the seminiferous tubules of the adult testis. The "Leydig-like cells" present in the stroma contained occasional dense bodies and crystalloids which characterize the Leydig cells of the fetal testis. Delta 5-3 beta hydroxysteroid dehydrogenase activity was demonstrated in the periphery of lipid droplets and lysosome-like dense bodies of the Leydig cells, and in some Sertoli cells. The findings support the theory that gonadoblastoma arises in a dysgenetic testis rather than in a dysgenetic ovary.

Some new observations in an intracranial germinoma

A case of an intracranial germinoma from the suprasellar region of a 9-year-old girl was examined in the electron microscope. The tumor consists, for the most part, of both large polygonal and small lymphocyte-like elements. Annulate lamellae are common in the epithelial cells. The small blood vessels are fenestrated, and the endothelial cells contain tubular bodies, membrane-bounded vacuoles containing dense fluid and occasional tubules, arrays of tubules within the nuclear envelope and rough endoplasmic reticulum, and a markedly irregular luminal surface. Dense, lamellated structures are present in the widened, collagen-containing perivascular spaces.