Diagnosis of testicular carcinoma in situ, (intratubular- and micro-invasive) seminoma and embryonal carcinoma using direct enzymatic alkaline phosphatase reactivity on frozen histological sections.

Hans Stoop (1) , Wim Kirkels (1, 2) , Gert Dohle (2) , Ad Gillis (1) , Michael den Bakker (1) , Katharina Biermann (1) , J Wolter Oosterhuis (1) , Leendert Looijenga (3)

1 Pathology
2 Urology
3 Pathology

Aims: Testis-sparing surgery might benefit quality of life, but can only be applied with histological examination for seminoma and embryonal carcinoma, and carcinoma in situ (CIS). Diagnosis is based on paraffin-embedded tissue, therefore a delay in further surgery is mostly unavoidable. Methods and Results: A total of 4,093 snap frozen samples and paraffin tissue of 1,500 patients were included. Besides standard H & e staining, the direct enzymatic alkaline phosphatase reactivity (dAP) test (duration 15 minutes). Endothelial cells served as control for the dAP test. Positive staining was found in CIS (n = 965), seminoma (n = 1035), embryonal carcinoma (n = 584), either intratubular. Differentiated non-seminomatas (n = 1238) showed variable staining. No staining was identified in spermatocytic seminomas (n = 5), testicular lymphomas (n = 42), testicular rhabdomyosarcomas (n = 7), Leydig cell tumors (n = 31), Sertoli-cell-only nodules (n = 4), (epi)dermoid cyst (n = 16), normal testicular parenchyma (n = 116), testicular torsion (n = 32) and inflammation of the epididymis (n = 19). Conclusion: The dAP test is informative, reproducible, and easy tool to diagnose CIS, seminoma and embryonal carcinoma on frozen tissue sections, being of great value in the context of sparing surgery.

Mots clés: Medicine

Hans Stoop, Wim Kirkels, Gert Dohle, Ad Gillis, Michael den Bakker, et al.. Diagnosis of testicular carcinoma in situ, (intratubular- and micro-invasive) seminoma and embryonal carcinoma using direct enzymatic alkaline phosphatase reactivity on frozen histological sections.. Histopathology, 2011, 58 (3), pp.440. ⟨10.1111/j.1365-2559.2011.03767.x⟩. ⟨hal-00614748⟩