Metastatic seminomas in lymph nodes: CD10 immunoreactivity can be a pitfall of differential diagnosis

Int J Clin Exp Pathol. 2013;6(3):498-502. Epub 2013 Feb 15.

Abstract

Metastatic seminoma can potentially be confused with lymphoma in a lymph node biopsy. Here, we report a case in which the immunohistochemistry of CD10 was a pitfall in the differential diagnosis of a metastatic seminoma, and further present a brief study of CD10 expression in a seminoma series. A 67-year-old man, who had a history of lobectomy of the lung due to squamous cell carcinoma 2 years prior, showed lymphadenopathy of the neck and the paraaorta on follow-up study by fluorodeoxyglucose-positron emission computer tomography scan. The biopsy of the cervical node demonstrated infiltration of large atypical cells. The results of the screening immunohistochemistry were CD20(-), CD3(-), CD10(+), CD30(-), AE1/AE3(-), and placental alkaline phosphatase(-), providing the impression of CD10-positive lymphoma. However, the following studies revealed germ cell characteristics [OCT3/4(+), SALL4(+), and CLDN6(+)], confirming the diagnosis of seminoma. We further evaluated CD10 expression in a series of seminomas (n=16). Strong positivity was observed in 14 cases; partial and weak positivity, in 2 cases. These findings should be considered in the differential diagnosis of seminoma.

Keywords: CD10; OCT3/4; PLAP; Testicular seminoma.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Alkaline Phosphatase / metabolism
  • Biomarkers, Tumor / metabolism
  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / metabolism
  • Carcinoma, Squamous Cell / secondary
  • Diagnosis, Differential
  • GPI-Linked Proteins / metabolism
  • Humans
  • Isoenzymes / metabolism
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / metabolism
  • Lung Neoplasms / secondary
  • Lymph Nodes / pathology*
  • Lymphatic Diseases / diagnosis*
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neprilysin / metabolism*
  • Seminoma / metabolism
  • Seminoma / secondary*
  • Testicular Neoplasms / metabolism
  • Testicular Neoplasms / pathology*
  • Young Adult

Substances

  • Biomarkers, Tumor
  • GPI-Linked Proteins
  • Isoenzymes
  • Alkaline Phosphatase
  • alkaline phosphatase, placental
  • Neprilysin