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Published in Joseph Kovi, Hung Dinh Duong, Frozen Section In Surgical Pathology: An Atlas, 2019
Leydig cell tumor. Of 6000 testicular tumors recorded in the American Testicular Tumor Registry, 3% were classified as Leydig cell tumors. The tumor affects children and young adults. Microscopically, the neoplasm is composed of relatively large polygonal or hexagonal cells. The nuclei are vesicular, uniform, and the nucleoli are inconspicuous. The cytoplasm is eosinophilic or vacuolated. The tumor cells are arranged in cords, nests, and trabeculae (Figures 140 and 141). In the American Testicular Tumor Registry about 10% of Leydig cell tumors were categorized as malignant. The most reliable microscopic evidence of malignant behavior is an increased number of mitotic figures in the tumor.296
Testis and scrotum
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Interstitial cell tumours arise from Leydig or Sertoli cells. A Leydig cell tumour masculinises; a Sertoli cell tumour feminises. They are typically small well-circumscribed tumours with a yellow cut surface. Microscopically, the cells are usually uniform and closely packed. Approximately 10% are malignant.
Scrotum
Published in Swati Goyal, Essentials of Abdomino-Pelvic Sonography, 2018
Gonadal stromal tumors: Leydig cell tumor: Testicular enlargement and gynecomastiaUSG—Small, solid hypoechoic with peripheral flow on DopplerSertoli cell: Often B/L and multifocal
Occult symptomatic bilateral pure Leydig cell tumors in a postmenopausal woman: a case report
Published in Gynecological Endocrinology, 2021
S. Ahmed Hussain, Elizabeth A. Dubil, Javier N. De Luca-Johnson, Michael Johnston
On pathologic gross examination, sectioning of the right ovary revealed a well-circumscribed soft tan-yellow mass within the ovarian cortex measuring 1.0 × 0.9 × 0.8 cm. Sectioning of the left ovary revealed no discrete masses or lesions. On microscopic examination, the right ovarian mass was composed of sheets of medium to large cells with abundant eosinophilic cytoplasm, uniform round nuclei, vesicular chromatin, and prominent nucleoli (Figure 2). Definitive Reinke crystals were not visualized and a Sertoli cell component was not seen. Overt features of malignancy (increased mitotic activity, nuclear atypia, hemorrhage, or necrosis) were not identified. The cells of interest were strongly and diffusely positive for markers of sex cord-stromal differentiation (calretinin and inhibin) and were negative for pancytokeratin and EMA (Figure 3). In addition to the grossly identified left ovarian mass, numerous microscopic nests and cords of identical-appearing cells were present in the right ovary and in additional sections from the left ovary (Figure 3). Hyperplasia of non-neoplastic hilus cells was identified within the left ovarian hilus. The constellation of pathologic findings in concert with the clinical features was consistent with the bilateral presentation of pure ovarian Leydig cell tumor.
Diagnostic Accuracy of Intraoperative Frozen Section Analysis in Correlation with Histopathological Diagnosis of Ovarian Tumors in a Tertiary Care Center – A Retrospective Study
Published in Cancer Investigation, 2021
AC Senthil Kumar, Vimal Chander, Jayaganesh Parthasarathy
In this study, 6 cases showed partial concordance wherein the tumor category (benign or malignant) was the same in frozen sections and routine histopathology sections but the diagnosis was different. 1 case of benign mucinous cystadenoma diagnosed on frozen sections, on subsequent routine processing in histopathology, showed additional features of cartilage, squamous epithelial lining and ciliated epithelial lining and was diagnosed as benign cystic teratoma. This could be attributable to limited sampling and also the unfixed nature of the cystic lesion during frozen sections. 1 case showed features of Sertoli-Leydig cell tumor on frozen sections turned out to be a high-grade serous carcinoma on routine histopathology sections. This is due to the fact that the tumor cells were arranged in sheets with invasion in frozen sections and also with clinical history of minimal hirsuitism. The subsequent histopathology sections showed foci of papillary areas and abundant mitotic figures and hence the diagnosis.
Ovarian Leydig cell tumour diagnosis in a postmenopausal woman with uterine bleeding: a case report and literature review
Published in Journal of Obstetrics and Gynaecology, 2022
Asuka Higuchi, Shunichiro Tsuji, Tsukuru Amano, Kyoko Kasahara, Fuminori Kimura, Takashi Murakami
Leydig cell tumours are a rare subgroup of steroid cell tumours, accounting for approximately 0.1% of all ovarian tumours. These usually produce androgens and cause virilisation with signs of hirsutism, temporal balding, polycythaemia, and endometrial atrophy (Boehnisch et al. 2019). Here, we present a case of a rare Leydig cell tumour with postmenopausal uterine bleeding due to oestrogenic effect and polycythaemia due to androgenic effect. Although the initial consultation was for postmenopausal uterine bleeding, additional screening revealed polycythaemia and virilisation leading to the diagnosis of an ovarian tumour. Additionally, we found improvement in polycythaemia after the surgical removal of the ovarian Leydig cell tumour.