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Malignant mediastinal germ cell tumor with pure hepatoid differentiation
Ingo Theuerkauf1, Cristoph Axmann, Martin Wolff
1Department of Pathology, University of Bonn, Sigmund-Freud-Str. 25, 533127 Bonn, Germany. theuerkauf@mailer.meb.uni-bonn.de
Abstract:
We describe a germ cell tumor of anterior mediastinal origin, with pure hepatoid differentiation and elevated serum AFP in a 41-year-old man. This is the first report of such a neoplasm analyzed by conventional stains and immunohistochemistry. Hepatocellular differentiation was proved by immunoreactivity with HepPar-1 and alpha-fetoproein (AFP), membranous expression of carcinoembryonic antigen (CEA-poly) in a canalicuar pattern, and focal expression of cytokeratin 19 in abortive ductular structures. Our investigation shows that mediastinal germ cell tumors with hepatoid components typically arise in middle-aged men; they are of pure hepatoid differentiation, as demonstrated here, or exclusively associated with yolk sac structures.