Histopathologische Befundung von Keimzelltumoren – worauf ist zu achten?

Zusammenfassung

Die Keimzelltumoren machen den Großteil der Hodentumoren aus und bilden eine heterogene Gruppe an Tumoren, die sich biologisch unterschiedlich verhalten. Aufgrund des Auftretens in unterschiedlichen Altersgruppen, ihrer morphologischen Charakteristika und der molekularen Veränderungen werden sie in 3 verschiedene Gruppen (Typ I–III) unterteilt. Die genaue histopathologische Analyse eines Orchiektomieresektats, die Zuordnung in die genannten 3 Gruppen und die genaue Benennung aller Subtypen mit prozentualer Verteilung ist für die Therapie und Prognose eines Patienten mit Keimzelltumor sehr wichtig. In diesem Artikel wird die Vorgehensweise bei der Aufarbeitung eines Orchiektomieresektats und die histopathologische Analyse des Hodentumorgewebes geschildert und dargestellt, in welchen Situationen Hilfsmittel wie immunhistochemische oder molekularpathologische Untersuchungen notwendig sind. Ferner wird die aktuelle Einteilung der Keimzelltumoren des Hodens anhand der gültigen WHO-Klassifikation geschildert und diskutiert.

Abstract

Germ cell tumours (GCT) are the most common testicular tumours and form a heterogenous group of tumours with different biological behaviour. Based on differences regarding patient age at first manifestation, morphological characteristics and molecular changes, they are divided into three different groups of GCTs (type I–III). For treatment and prognosis, an exact histopathological analysis of an orchiectomy resection specimen is very important, including the specification of all different histological subtypes with their proportional distribution. This article describes the approach of the preparation of a resection specimen and the histopathological analysis of a testicular tumour. In addition, it describes cases in which additional tools like immunohistochemical and molecular analyses are necessary. Furthermore, the current WHO classification of testicular GCT is discussed.

Schlüsselwörter

Seminom - Hoden - Keimzelltumor - Nicht-Seminom

Keywords

testicle - germ cell tumour - seminoma - non-seminomatous tumour

Publication History

Received: 21 May 2024

Accepted: 28 June 2024

Article published online:
05 September 2024

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