- INTRODUCTION
- I - RENAL NEOPLASMS
- Congenital mesoblastic nephroma
- Nephroblastoma (Wilms’ tumour)
- Rhabdoid tumour
- Clear cell sarcoma
- Renal primitive neuroectodermal tumour-Ewing Family Tumour
- Renal cell carcinoma (RCC)
- Metanephric Adenoma
- II - RHABDOMYOSARCOMA
- III - SOFT TISSUE TUMORS OTHER THAN RHABDOMYOSARCOMA
- MIXOID LESIONS
- Nodular fasciitis
- Lipoblastoma
- Myxoid liposarcoma
- Extraskeletal myxoid chondrosarcoma
- SPINDLE CELL LESIONS
- Nodular fasceiitis
- Fibromatosis
- Fibromatosis colli
- Fibrosarcoma of infancy
- Synovial sarcoma
- Neurofibroma
- Malignant peripheral nerve sheet tumour
- Schwannoma
- EPITHELIOID LESIONS
- Epithelioid sarcoma
- Alveolar soft part sarcoma
- MIXED LESIONS - Synovial sarcoma
- SMALL ROUND CELL LESIONS
- Neuroblastoma NOS
- Peripheral Neuroectodermal tumours (PNET/Ewing´s Sarcoma-)/Ewing Family tumours-EFT
- Desmoplastic small cell tumour
- IV – HISTIOCYTIC LESIONS
- Juvenile Xanthogranuloma
- Langerhans histiocytosis
- V- GERM CELL TUMOURS
- Teratoma
- Germinoma/seminoma
- Yolk sac tumour
- Embryonal carcinoma
- VI - LIVER
- Focal nodular hyperplasia
- Infantile hemangioendothelioma
- Mesenchymal hamartoma
- Inflammatory pseudotumor
- Hepatoblastoma
- Embryonal sarcoma
- VII- TUMORS OF THE PANCREAS
- Pancreatoblastoma
- Solid pseudo papillary-cystic tumour
- VIII- TUMORS OF RESPIRATORY TRACT
- Langerhans Histiocytosis
- Hamartoma
- Inflammatory pseudo tumour
- Carcinoid
- Pulmonary blastema of childhood (Pleuropulmonary blastema)
- IX-ADRENAL TUMOURS OTHER THAN NEUROBLASTOMA
- Adrenal cortical adenoma/carcinoma
- Pheochromocytoma
- X - OTHERS
- Juvenile granulose cell tumours
- Nasopharyngeal carcinoma
Paediatric Cytology (Recently updated)
Embryonal carcinoma
Clinical features
- Peak incidence in the first decade
- Pure forms are rare in children
- More common in the testis than in the ovary
- High serum human chorionic gonadotropin (HCG)
- Less commonly elevated serum alpha-fetoprotein
- Isosexual precocity: vaginal bleeding, amenorrhea, hirsutism
- Cellular smears
- Similar appearance to an adenocarcinoma:
- Sheets, nests, glandular or papillary formations
- Ragged-edged cell clusters
- Large pleomorphic cells
- Irregular nuclei
- Coarse chromatin
- Multiple prominent nucleoli
- Sparse cytoplasm
- Syncytiotrophoblast cells
- Necrotic background
Immunocytochemistry (see Table 1)
- Cytokeratin: positive
- CD30: positive
- Alpha-fetoprotein: positive (focal)
- OCT4: positive
- PLAP: positive (focal in syncytiotrophoblast cells)
- EMA: Negative
Modern diagnostic techniques
- Non-contributory
Differential diagnosis
- Germinoma
- Poorly cohesive cells
- More monotonous population
- Nuclei with clear chromatin and single nucleoli
- Cytoplasmic glycogen vacuoles
- Tigroid background
- Lymphocytes
- Placental alkaline phosphatase (PLAP): positive
- CD117:positive
- Cytokeratin: usually negative
- EMA: negative
- CD30: negative
- Carcinoma
- Rare in children
- CD30: negative
- Yolk sac tumour
- Mucoid background
- Less necrosis
- Smaller cells
- Intra and extra cytoplasmic hyaline globules
- Dense basement membrane-like matrix associated with neoplastic cells
- Alpha-fetoprotein: positive (intense)
- CD30:negative
Table 1- Immunophenotype of germ cell tumours
|
Marker: |
Seminoma |
Yolk sac tumour |
Embryonal carcinoma |
Choriocarcinoma |
|
AE1/AE3) |
+/- |
+ |
+ |
+ |
|
PLAP |
+ |
+ |
+ |
+/- |
|
AFP |
- |
+ |
+/- |
- |
|
Beta-HCG |
- (except in giant cells) |
- |
- |
+ |
|
S-100 protein |
- |
- |
- |
- |
|
LCA |
- |
- |
- |
- |
|
CD30 |
- (rarely +) |
- |
+ |
- |
|
OCT4 |
+ |
- |
+ |
- |
AFP-alpha-fetoprotein; CK- cytokeratin; HCG- human chorionic gonadotropin; LCA- leukocyte common antigen; PLAP- placenta-like alkaline phosphatase; + positive; +/- positive or negative; - negative.
