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Expression of terminal deoxynucleotidyl transferase (TdT) in classical seminoma: a potential diagnostic pitfall

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Abstract

Seminomas are the most frequent testicular tumors and in spite of specific markers some histological subtypes can be diagnostically challenging due to the potential overlap of morphologic features and a variant antigen expression. Terminal deoxynucleotidyl transferase (TdT) is a DNA polymerase present in hematogones, thymic T cells, lymphoblastic lymphoma/leukemia (LBL), and in some cases of acute myeloid leukemia but so far has not been described to be expressed in seminomas. After observing a reactivity of TdT in one case of seminoma, we analyzed ten additional tumors by immunohistochemistry to determine their spectrum of reactivity for TdT. In all seminoma cases investigated (10/10) as well as in two tumor-associated germ cell neoplasias in situ (2/2) the TdT staining intensity was variable but was often moderate to strong and restricted to the nucleus. We conclude that TdT expression in seminomas could represent a diagnostic pitfall in the differential diagnosis of LBL, particularly because both may lack CD45 and/or CD20 expression and—concerning relapse in long-term survivors of testicular cancer—LBL is the most frequent secondary neoplasm in the patients.

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Acknowledgments

We specially thank Simone Eckhart, Heike Eckhart-Weber and Nicole Neuhaus for their excellent technical support.

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Authors and Affiliations

  1. Institute of Pathology, Justus-Liebig-University, 35392, Giessen, Germany

    Alexander Brobeil & Stefan Gattenlöhner

  2. Institute of Pathology, Justus-Liebig-University, 35385, Giessen, Germany

    Alexander Brobeil

  3. Department of Urology, Pediatric Urology and Andrology, Justus-Liebig-University, 35392, Giessen, Germany

    Florian Wagenlehner

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  1. Alexander Brobeil
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  2. Florian Wagenlehner
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Correspondence to Alexander Brobeil.

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Brobeil, A., Wagenlehner, F. & Gattenlöhner, S. Expression of terminal deoxynucleotidyl transferase (TdT) in classical seminoma: a potential diagnostic pitfall. Virchows Arch 472, 433–440 (2018). https://doi.org/10.1007/s00428-018-2313-5

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  • DOI: https://doi.org/10.1007/s00428-018-2313-5

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