Dermoid cyst: Difference between revisions
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→Teratoma diagnosis: +Bone |
→Teratoma diagnosis: COnfirmed |
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The main components are: | The main components are: | ||
*Diagnosis as a teratoma | *Diagnosis as a teratoma | ||
*Ruling out an immature teratoma, and thereby establishing a diagnosis as a "mature (cystic) teratoma" | *Ruling out an immature teratoma, and thereby establishing a diagnosis as a "mature (cystic) teratoma". | ||
===Teratoma diagnosis=== | ===Teratoma diagnosis=== | ||
[[File:Histopathology of ovarian dermoid cyst.jpg|thumb|Mature cystic teratoma (dermoid) cyst, showing components from several germ layers.]] | [[File:Histopathology of ovarian dermoid cyst.jpg|thumb|Mature cystic teratoma (dermoid) cyst, showing components from several germ layers.]] | ||
The diagnostic criterion is a well-differentiated components from at least two germ layers (ectoderm, mesoderm and/or endoderm).<ref name="SahinAbdullazade2017">{{cite journal|last1=Sahin|first1=Hilal|last2=Abdullazade|first2=Samir|last3=Sanci|first3=Muzaffer|title=Mature cystic teratoma of the ovary: a cutting edge overview on imaging features|journal=Insights into Imaging|volume=8|issue=2|year=2017|pages=227–241|issn=1869-4101|doi=10.1007/s13244-016-0539-9}}</ref> Representative tissues of these are: | The diagnostic criterion is a well-differentiated components from at least two germ layers (ectoderm, mesoderm and/or endoderm).<ref name="SahinAbdullazade2017">{{cite journal|last1=Sahin|first1=Hilal|last2=Abdullazade|first2=Samir|last3=Sanci|first3=Muzaffer|title=Mature cystic teratoma of the ovary: a cutting edge overview on imaging features|journal=Insights into Imaging|volume=8|issue=2|year=2017|pages=227–241|issn=1869-4101|doi=10.1007/s13244-016-0539-9}}</ref><ref>{{cite web|url=https://www.pathologyoutlines.com/topic/ovarytumorteratomamature.html|title=Teratoma-mature|website=Pathology Outlines|author=Shannon Mingo Welter, M.D., Mahmoud A. Khalifa, M.D., Ph.D.}} Last author update: 10 August 2021</ref> Representative tissues of these are: | ||
*'''Ectoderm''': | *'''Ectoderm''': | ||
<gallery mode=packed> | <gallery mode=packed heights=180> | ||
File:Epidermis and epidermal appendages a mature cystic teratoma.jpg|Epidermis (stratified) and epidermal appendages | File:Epidermis and epidermal appendages a mature cystic teratoma.jpg|Epidermis (stratified) and epidermal appendages | ||
File:Nervous tissue in a mature cystic teratoma.jpg|Nervous tissue | File:Nervous tissue in a mature cystic teratoma.jpg|Nervous tissue | ||
| Line 31: | Line 31: | ||
</gallery> | </gallery> | ||
*'''Mesoderm''': | *'''Mesoderm''': | ||
<gallery mode=packed> | <gallery mode=packed heights=180>> | ||
File:Cartilage in a mature cystic teratoma.jpg|Cartilage | File:Cartilage in a mature cystic teratoma.jpg|Cartilage | ||
File:Histopathology of fatty tissue in a mature teratoma.jpg|Fatty tissue | File:Histopathology of fatty tissue in a mature teratoma.jpg|Fatty tissue | ||
| Line 38: | Line 38: | ||
Striated muscle, smooth muscle | Striated muscle, smooth muscle | ||
*'''Endoderm''': | *'''Endoderm''': | ||
<gallery mode=packed> | <gallery mode=packed heights=180>> | ||
File:Respiratory epithelium in a mature cystic teratoma.jpg|Respiratory epithelium (pseudostratified ciliated) | File:Respiratory epithelium in a mature cystic teratoma.jpg|Respiratory epithelium (pseudostratified ciliated) | ||
File:Histopathology of pancreatic tissue in a mature cystic teratoma.jpg| | File:Histopathology of pancreatic tissue in a mature cystic teratoma.jpg|Acinar glandular tissue (pancreatic tissue shown) | ||
File:Histopathology of choroid plexus tissue in a mature teratoma.jpg|Choroid plexus | File:Histopathology of choroid plexus tissue in a mature teratoma.jpg|Choroid plexus | ||
</gallery> | </gallery> | ||
:*Thyroid tissue | :*Thyroid tissue | ||
:*Gastrointestinal mucosa | :*Gastrointestinal mucosa | ||
===Immature teratoma=== | |||
The finding of immature tissues confer a diagnosis of immature teratomas: | |||
<gallery mode=packed heights=180>> | |||
File:Histopathology of immature neuroepithelium in immature teratoma.jpg|thumb|Immature neuroepithelium | |||
</gallery> | |||
Immature neuroepithelium is the most common finding, but immature cartilage and/or skeletal muscle are occasionally seen.<ref name=":5">{{Cite book |title=Modern surgical pathology |date=2009 |publisher=Saunders/Elsevier | vauthors = Weidner N |isbn=9781416039662 |edition=2nd |location=Philadelphia, PA |oclc=460883320}}</ref> | |||
==See also== | ==See also== | ||
*[[Ovarian cyst]] | *[[Ovarian cyst]] | ||
{{Bottom}} | {{Bottom}} | ||
Latest revision as of 19:57, 8 November 2023
Author:
Mikael Häggström [note 1]
Fixation
Generally 10% neutral buffered formalin.
Gross processing
Example gross report:
| (Optionally: A. Labeled - __ The specimen is received in formalin and consists of) tan-pink to yellow cystic ovarian tissue measuring __ cm. The cyst lining reveals multiple patches of hair with associated greasy yellow keratinous material. Cross-sections show several plate-like areas of rubbery grey-white cartilage. Representative sections are submitted for microscopic examination in three cassettes. |
Tissue sampling
Generally sample approximately 3 cassettes in order to be able to rule out immature elements.
There is no need to sample by Rokitansky nodules as these do not have any significant risk of containing immature elements.
Microscopic evaluation
The main components are:
- Diagnosis as a teratoma
- Ruling out an immature teratoma, and thereby establishing a diagnosis as a "mature (cystic) teratoma".
Teratoma diagnosis
The diagnostic criterion is a well-differentiated components from at least two germ layers (ectoderm, mesoderm and/or endoderm).[1][2] Representative tissues of these are:
- Ectoderm:
-
Epidermis (stratified) and epidermal appendages -
Nervous tissue -
Brain tissue (here ventricle-forming)
- Mesoderm:
-
Cartilage -
Fatty tissue -
![Bone and teeth[notes 1]](https://upload.wikimedia.org/wikipedia/commons/thumb/2/2c/Histopathology_of_bony_tissue_in_a_mature_teratoma.jpg/500px-Histopathology_of_bony_tissue_in_a_mature_teratoma.jpg?utm_source=commons.wikimedia.org&utm_campaign=imageinfo&utm_content=thumbnail)
Bone and teeth[notes 1]
![Bone and teeth[notes 1]](/File:Histopathology_of_bony_tissue_in_a_mature_teratoma.jpg)
Striated muscle, smooth muscle
- Endoderm:
-
Respiratory epithelium (pseudostratified ciliated) -
Acinar glandular tissue (pancreatic tissue shown) -
Choroid plexus
- Thyroid tissue
- Gastrointestinal mucosa
Immature teratoma
The finding of immature tissues confer a diagnosis of immature teratomas:
-
Immature neuroepithelium
Immature neuroepithelium is the most common finding, but immature cartilage and/or skeletal muscle are occasionally seen.[3]
See also
Notes
- ↑ Teeth also contain ectodermal (outer) layers of embryonic tissues.
- . Tooth germ. Encyclopaedia Britannica. Retrieved on 2021-03-31.
- ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.
Main page
References
- ↑ Sahin, Hilal; Abdullazade, Samir; Sanci, Muzaffer (2017). "Mature cystic teratoma of the ovary: a cutting edge overview on imaging features ". Insights into Imaging 8 (2): 227–241. doi:. ISSN 1869-4101.
- ↑ Shannon Mingo Welter, M.D., Mahmoud A. Khalifa, M.D., Ph.D.. Teratoma-mature. Pathology Outlines. Last author update: 10 August 2021
- ↑ Modern surgical pathology (2nd ed.). Philadelphia, PA: Saunders/Elsevier. 2009. ISBN 9781416039662. OCLC 460883320.
Image sources