Image Description
Differential Diagnosis: Regressed germ cell tumor (GCT) (which obviously has metastatic potential) must be distinguished from non-neoplastic scarring in the testis resulting from injuries or vascular lesions.
Features favoring regressed GCT include: clinical - the presence of retroperitoneal metastasis; gross - discrete nodular or stellate scar in the orchiectomy specimen; microscopic - presence of germ cell neoplasia-in-situ, Leydig cell hyperplasia, microliths, tubular atrophy, and impaired spermatogenesis in the surrounding testis; lymphoplasmacytic infiltrate, intratubular shard-like coarse calcifications, angiomatous foci, ghost tubules, and siderophages within the scar.
The image shows "ghost tubules" within the scar in a regressed GCT of the testis.
Features favoring regressed GCT include: clinical - the presence of retroperitoneal metastasis; gross - discrete nodular or stellate scar in the orchiectomy specimen; microscopic - presence of germ cell neoplasia-in-situ, Leydig cell hyperplasia, microliths, tubular atrophy, and impaired spermatogenesis in the surrounding testis; lymphoplasmacytic infiltrate, intratubular shard-like coarse calcifications, angiomatous foci, ghost tubules, and siderophages within the scar.
The image shows "ghost tubules" within the scar in a regressed GCT of the testis.