Tumor de células de la granulosa testicular de tipo adulto. Presentación de un nuevo caso y revisión de la literatura / Adult type granulosa cell testicular tumor. Case report and bibliographic review

OBJETIVO: Describir y conocer los tumores de células de la granulosa testicular del adulto (TCG) (clasificado como tumores del estroma y cordones sexuales de las gónadas) ya que conforman una variante rara con pocos casos publicados y de comportamiento clínico poco conocido. Método; Presentación de un nuevo caso de TCG testicular del adulto en un varón de 59 años, asintomático, con hallazgo ecográfico de una masa intratesticular de 3,3 cm heterogénea, con áreas sólidas y quísticas; marcadores tumorales y estudio de extensión negativos. RESULTADO: Confirmación del caso con análisis anatomopatológico e inmunohistoquímico, similar a su homólogo ovárico. CONCLUSIONES: El TCG del adulto, es un tumor infrecuente de comportamiento incierto. Aunque suele cursar con buen pronóstico, se ha descrito su potencial metastásico incluso años después de la orquiectomía, por lo que requiere un seguimiento a largo plazo

OBJECTIVE: To describe the adult type granulosa cell testicular tumors (classified as sex cord-stromal tumor) due to their behavior, hardly known with a small number of cases reported. METHOD: We report a new case of a 59-year-old man presenting an adult type granulosa cell tumor of the testis (AGCTT), painless, with a 3.3 centimeter intratesticular heterogeneous mass on ultrasound, with solid and cystic areas. Serum tumor markers and extension study were negative. RESULTS: Histologic and inmunohistochemical studies confirmed an AGCTT, similar to its ovarian counterpart. CONCLUSION: AGCTT are rare neoplasms with unpredictable behavior. Their metastatic potential has been described, reason why they need a long follow-up; however, they usually have a good prognosis

[Adult type granulosa cell testicular tumor. Case report and bibliographic review.] / Tumor de células de la granulosa testicular de tipo adulto. Presentación de un nuevo caso y revisión de la literatura.

OBJETIVE: To describe the adult type granulosa cell testicular tumors (classified as sex cordstromal tumor) due to their behavior, hardly known with a small number of cases reported. METHOD: We report a new case of a 59-year-old man presenting an adult type granulosa cell tumor of the testis (AGCTT), painless, with a 3.3 centimeter intratesticular heterogeneous mass on ultrasound, with solid and cystic areas. Serum tumor markers and extension study were negative. RESULTS: Histologic and inmunohistochemical studies confirmed an AGCTT, similar to its ovarian counterpart. CONCLUSION: AGCTT are rare neoplasms with unpredictable behavior. Their metastatic potential has been described, reason why they need a long follow-up; however, they usually have a good prognosis.

Applying the Paris System for Reporting Urine Cytology Increases the Rate of Atypical Urothelial Cells in Benign Cases: A Need for Patient Management Recommendations.

The Paris System (TPS) for reporting urinary cytology attempts to unify the terminology in this field. OBJECTIVES: To analyze the impact of adopting TPS by measuring nomenclature agreement and cytohistological correlation. MATERIALS AND METHODS: Voided urine liquid-based cytology samples corresponding to 149 biopsy-proven cases (76 high-grade carcinomas, 40 low-grade carcinomas, and 33 benign lesions), were reclassified by the same pathologist using TPS. Diagnostic agreement and sensitivity for both nomenclature systems was measured. RESULTS: When using TPS, the rate of atypical samples increased 8 times (from 3 to 24.2%) in benign cases, 10 times (from 2.5 to 25%) in low-grade carcinomas, and 2.4 times (from 6.6 to 15.8%) in high-grade carcinomas. The false-positive rate (abnormal cytology in negative or low-grade carcinoma cases) increased from 11 to 34.2%. Sensitivity was higher (63 vs. 49%) with TPS at the expense of a lower specificity (73 vs. 91%). The agreement between both nomenclatures was moderate for negative and high-grade carcinoma cases (k = 0.42 and 0.56, respectively) and weak for low-grade tumors (k = 0.35). CONCLUSIONS: Adopting TPS for reporting urine cytology results in a considerable increase in atypical diagnoses, improving sensitivity but lowering specificity. Appropriate management recommendations for patients with an atypical cytological diagnosis are required.

Increased risk of malignancy for non-atypical urothelial cell groups compared to negative cytology in voided urine. Morphological changes with LBC.

Liquid-based cytology (LBC) has recently become the preferred method for urine cytology analysis, but differences with conventional cytology (CC) have been observed. The purpose of this study is to analyze these differences and the clinical relevance of non-atypical urothelial cell groups (UCG) in voided urine specimens. Reporting terminology is discussed. Initially, diagnostic categories from 619 LBC and 474 CC samples, reviewed by five different pathologists, were compared (phase 1). Five years after LBC was implemented and applying strict cytologic criteria for UCG diagnosis, 760 samples were analyzed (phase 2) and compared to previous LBC specimens. Diagnostic differences, interobserver variability and clinicopathological correlation with a 6-month follow-up, were analyzed. UCG increased from 6.5% with CC to 20.7% (218%, 3.2 fold, P < 0.0001) with LBC. This difference was not related to interobserver variability. Five years later, the rate of UCG had decreased to 13 2%. While 6% of cases with a negative cytology had urothelial carcinoma (UC) within 6 months of diagnosis, this percentage increased to 15.7% with UCG. The sensitivity of the UCG category for UC was low (30.4%), but the specificity and the negative predictive value (NPV) were high (87.1% and 94%, respectively). LBC increases UCG when compared to CC. This can be corrected with observers experience and using set cytological criteria. Due to its association with carcinoma, the presence of UCG in voided urine should be framed in a diagnostic category other than "negative for malignancy." Diagn. Cytopathol. 2016;44:582-590. © 2016 Wiley Periodicals, Inc.