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Leydig Cell Pathology

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  • Leydig Cell Pathology

    Hi everyone I need help on my pathology report. My Urologist said my Leydig cell is malignant but my Pathology report says otherwise. I also showed my pathology report to Dr. Einhorn which he disagrees with my urologist. I’m just confused.


    Accession No: SHS-20-04521
    SPECIMEN SUBMITTED:
    RIGHT TESTICLE AND CORD

    SUBMITTED ICD9 CODE: N50.89


    DIAGNOSIS (MICROSCOPIC):
    A. testicle, right, orchiectomy
    -- LEYDIG CELL TUMOR, 0.5 CM, EXCISED (SEE COMMENT)

    TOLAND/SCAPA/LOWE

    COMMENT: Histologic sections show a well-demarcated,
    non-encapsulated proliferation of discohesive histiocytoid cells
    with round nuclei, prominent nucleoli, and abundant eosinophilic
    cytoplasm in a background of unremarkable seminiferous tubules.
    Scattered intracytoplasmic Reinke crystals are present. No nuclear
    atypia, mitotic figures, or necrosis is identified. The nodule abuts
    but does not invade the tunica albuginea.

    Case reviewed at GU Consensus conference with Drs. Troxell, Higgins,
    Lei, and Kunder in attendance.
    TESTIS: Radical Orchiectomy
    SPECIMEN
    Specimen Laterality: Right
    TUMOR
    Histologic Type: Leydig cell tumor
    Tumor Size: 0.5cm x 0.4cm x 0.4cm
    Tumor Focality: Unifocal
    Tumor Extension: Tumor limited to testis
    Lymphovascular Invasion: Not identified
    MARGINS
    Spermatic Cord Margin: Uninvolved by tumor
    LYMPH NODES
    Regional Lymph Nodes: No lymph nodes submitted or found
    PATHOLOGIC STAGE CLASSIFICATION (pTNM, AJCC 8th Edition)
    Primary Tumor (pT): pT1a
    Regional Lymph Nodes (pN): pNX

    ANCILLARY STUDIES:
    If ancillary studies are indicated they may be performed on block
    A6, which contains approximately 5% tumor.

    CLINICAL HISTORY: Right testicular mass.


    OPERATION: Right radical orchiectomy

    GROSS DESCRIPTION: One specimen is received labeled with the
    patient's name and medical record number.

    The specimen labeled "right testicle" is received in formalin and
    consists of one radical orchiectomy specimen, 10.7 x 4.2 x 2.5 cm
    and weighing 20 g. 5.0 x 8.0 x 2.0 cm in the spermatic cord is 7.3
    cm in length by 1.6 cm in average diameter. The tunica vaginalis
    detaches with ease and is inked black. The specimen is bivalved to
    reveal a firm, light brown, well-demarcated mass, 0.5 x 0.4 x 0.4 cm
    within the inferior testicular parenchyma underlying the tunica
    albuginea. No gross necrosis or hemorrhage are identified. The
    tumor does not invade the tunica albuginea. The tumor occupies 1% of
    the testicular parenchyma. The tumor does not the spermatic cord or
    epididymis. The remaining testicular parenchyma is tan, spongiform,
    and unremarkable. No additional lesions are identified. The
    spermatic cord is serially sectioned to reveal tan-pink, smooth,
    unremarkable cut surfaces. The epididymis is serially sectioned to
    reveal tan, smooth, unremarkable cut surfaces. Representative
    sections are submitted as follows:
    A1 - spermatic cord resection margin, en face
    A2 - midsection of spermatic cord
    A3 - junction of distal spermatic cord to testis
    A4 - epididymis and rete testis
    A5-A6 - sections of mass, entirely submitted
    A7 - Section of uninvolved testicular parenchyma

  • #2
    Interesting, you don't see a lot of lydig cell. They are very much so usually benign. I think it's only about 1 in 10 that are malignent. They don't respond well to chemo so I'm glad to see there's not evidence of spread to the spermatic cord.

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