Diagnostic immunopathology of germ cell tumors

Abstract

This chapter reviews current data on diagnostic immunohistochemistry of germ cell tumors (GCT), analyzing stage-specific pluripotentiality markers as well as organ-specific ones. The genes and developmental role of each antibody are discussed, and a hands-on approach to the use of commercially available antibodies is provided. The sequential expression of pluripotentiality markers represents a substantial advance in diagnosis, since it categorizes the developmental stage of the tumor which is of paramount importance in establishing not only a histologic diagnosis but the differentiation and pluripotency status. Both antibodies frequently used clinically and those employed mainly in research are analyzed. The role of classical antibodies in GCT diagnosis is summarized, as well as a description of tissue specific markers useful in identifying areas of embryonal and somatic differentiation in seminoma, yolk sac tumors, and teratomas. The recent advances in the immunohistochemical profile of spermatocytic tumors are also discussed.