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Gonadoblastoma: an immunohistochemical study and comparison to S ertoli cell nodule with intratubular germ cell neoplasia, with pathogenetic implications
Author(s) -
Kao ChiaSui,
Ulbright Thomas M,
Idrees Muhammad T
Publication year - 2014
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.12444
Subject(s) - gonadoblastoma , sertoli cell , immunohistochemistry , pathology , biology , germ cell , pathogenesis , cell , medicine , endocrinology , spermatogenesis , genetics , gene , karyotype , chromosome
Aims To investigate the immunohistochemical properties of the sex cord cells of gonadoblastoma and Sertoli cell nodule with intratubular germ cell neoplasia unclassified ( IGCNU ) as a means of objective distinction and to provide insight into the pathogenesis. Methods and results Immunohistochemical stains for SOX 9, F ox L 2 and SF ‐1 were performed on 10 gonadoblastomas (all phenotypical females) and 14 S ertoli cell nodules with IGCNU in normal phenotypical males with coexisting germ cell tumours. The sex cord cells of gonadoblastomas showed strong, diffuse F ox L 2 and SF ‐1 positivity and focal weak to moderate SOX 9 reactivity, whereas those of S ertoli cell nodules with IGCNU were uniformly, strongly positive for SOX 9 and SF ‐1, while negative for F ox L 2. Conclusions Coexpression of SOX 9 and F ox L 2 in the sex cord cells of gonadoblastomas provides evidence that these morphologically ambiguous sex cord cells are incompletely differentiated. The strong, diffuse SOX 9 and SF ‐1 positivity and absence of F ox L 2 reactivity in the S ertoli cell nodules with IGNCU support full S ertoli cell differentiation of the sex cord cells and distinguish them from gonadoblastomas. Deficient SOX 9 expression in gonadoblastoma supports a current model of pathogenesis where immature germ cells, in the absence of well‐formed S ertoli cells, retain a fetal phenotype and susceptibility to malignant transformation.