muramidase and Testicular-Neoplasms

Myeloid sarcoma (MS) is defined as an extramedullary mass-forming lesion composed of immature myeloid cells. It is a rare but well-known manifestation of acute myeloid leukemia. Pediatrics testicular MS may pose a possible diagnostic challenge, an issue that is underscored in the few testicular pediatric MS cases reported in the literature. Herein, we report a series of 5 cases of pediatric testicular MS that are evaluated at the morphologic and immunohistochemical levels with correlation with the KMT2A (MLL) rearrangement status. Three patients presented with no prior history of acute myeloid leukemia. All 5 cases showed monoblastic morphology; positive for CD33, CD43, CD68, CD163, CD4 (dim), and lysozyme; and negative for CD10, CD34, CD117, and myeloperoxidase. KMT2A (MLL) rearrangement was detected in 4 of the 5 cases. In the literature, 8 more cases of pediatric testicular lymphoma were reported. Most of them showed monocytic differentiation and KMT2A (MLL) rearrangement was reported in 3 of the cases. In conclusions, testicular MS in pediatric patients shows monoblastic differentiation which may be attributed to the KMT2A (MLL) rearrangement. We also highlight the importance of using an extended immunohistochemistry panel in the diagnosis of MS.

Topics: Antigens, CD; Antigens, CD34; Antigens, Differentiation, Myelomonocytic; CD4 Antigens; Child; Child, Preschool; Gene Rearrangement; Histone-Lysine N-Methyltransferase; Humans; Immunohistochemistry; In Situ Hybridization, Fluorescence; Infant; Leukemia, Myeloid, Acute; Leukosialin; Male; Muramidase; Myeloid-Lymphoid Leukemia Protein; Neprilysin; Peroxidase; Proto-Oncogene Proteins c-kit; Receptors, Cell Surface; Sarcoma, Myeloid; Sialic Acid Binding Ig-like Lectin 3; Testicular Neoplasms

A testicular malignant teratoma containing embryoid bodies and other embryonic and extra-embryonic structures in various stages of development has been examined by several histochemical and immunohistological techniques to study the distribution of various substances in the teratomatous elements. The substances demonstrated included various types of mucins; argyrophil, argentaffin, Paneth cells and haemosiderin granules; alpha-fetoprotein, alpha-l-anti-trypsin, lysozyme, beta-HCG and CEA. The significance of the findings is discussed in relation to early embryonic development.

Topics: Adult; alpha 1-Antitrypsin; alpha-Fetoproteins; Carcinoembryonic Antigen; Chorionic Gonadotropin; Chorionic Gonadotropin, beta Subunit, Human; Histocytochemistry; Humans; Immunologic Techniques; Male; Mucins; Muramidase; Peptide Fragments; Teratoma; Testicular Neoplasms

Topics: Adult; Dysgerminoma; Esophageal Neoplasms; Female; Herpes Zoster; Humans; Lymphoma, Large B-Cell, Diffuse; Male; Middle Aged; Muramidase; Radiotherapy; Testicular Neoplasms