Immunophenotypic Characterization of Germ Cell Tumor-Derived Primitive Neuroectodermal Tumors: Evidence for Frequent Neuronal and/or Glial Differentiation.

Publisher: College of American Pathologists Country of Publication: United States NLM ID: 7607091 Publication Model: Print Cited Medium: Internet ISSN: 1543-2165 (Electronic) Linking ISSN: 00039985 NLM ISO Abbreviation: Arch Pathol Lab Med Subsets: MEDLINE

Publication: Northfield, Ill. : College of American Pathologists
Original Publication: Chicago, American Medical Assn.

Cell Differentiation* ; Immunohistochemistry*; Biomarkers, Tumor/*analysis ; Neoplasms, Germ Cell and Embryonal/*chemistry ; Neuroectodermal Tumors, Primitive, Peripheral/*chemistry ; Neuroglia/*chemistry ; Neurons/*chemistry ; Testicular Neoplasms/*chemistry; Adolescent ; Adult ; Chromogranin A/analysis ; Glial Fibrillary Acidic Protein/analysis ; Humans ; Male ; Middle Aged ; Neoplasms, Germ Cell and Embryonal/pathology ; Neoplasms, Germ Cell and Embryonal/surgery ; Neuroectodermal Tumors, Primitive, Peripheral/pathology ; Neuroectodermal Tumors, Primitive, Peripheral/surgery ; Neuroglia/pathology ; Neurons/pathology ; Phenotype ; Predictive Value of Tests ; S100 Proteins/analysis ; SOXC Transcription Factors/analysis ; Synaptophysin/analysis ; Testicular Neoplasms/pathology ; Testicular Neoplasms/surgery ; Young Adult

Context.—: Primitive neuroectodermal tumors (PNETs) may arise as a somatic-type malignancy in germ cell tumors. In this setting, most PNETs resemble those of the central nervous system and lack chromosome 22 translocations. However, description of the morphologic and differentiation spectrum of PNETs arising from germ cell tumors is lacking.
Objective.—: To investigate the morphologic and immunohistochemical features of these tumors, concentrating on neuronal and glial features.
Design.—: We selected cases based on a morphologically identifiable glial and/or differentiated neuronal component in association with the undifferentiated PNET. Immunohistochemistry for glial fibrillary acidic protein, S100 protein, synaptophysin, chromogranin A, and SOX11 was performed on tumors with available material, with the scoring of both staining intensity (0-3) and extent (0-3). Thirteen qualifying PNETs of testicular origin with available immunohistochemical stains or stainable material were identified. The complete stain panel was performed in 10 tumors.
Results.—: SOX11 demonstrated positive staining in the undifferentiated PNET component of all tumors (10 of 10) and was rarely positive in the differentiated (ie, neuronal/glial) component (1 of 10; focal and weak); synaptophysin was slightly less sensitive in the undifferentiated component (12 of 13; often focal and weak) and also showed positivity in the neuronal/glial component (5 of 13). Glial fibrillary acidic protein and S100 were more frequently positive in the differentiated areas (83% and 77%, respectively) compared with undifferentiated areas (25% and 17%, respectively).
Conclusions.—: SOX11 is a sensitive immunohistochemical marker for testicular PNET, particularly those lacking differentiation. Testicular PNETs often demonstrate glial and/or neuronal differentiation. Differentiation is marked by the acquisition of S100 and glial fibrillary acidic protein expression and SOX11 loss.
Competing Interests: The authors have no relevant financial interest in the products or companies described in this article.

0 (Biomarkers, Tumor)
0 (CHGA protein, human)
0 (Chromogranin A)
0 (GFAP protein, human)
0 (Glial Fibrillary Acidic Protein)
0 (S100 Proteins)
0 (SOX11 protein, human)
0 (SOXC Transcription Factors)
0 (SYP protein, human)
0 (Synaptophysin)

Date Created: 20201208 Date Completed: 20210913 Latest Revision: 20210913

20231215

10.5858/arpa.2020-0352-OA

33290506