Cytopathology competency assessment
Germ cell tumors (GCTs)

Topic Completed: 1 September 2012

Revised: 13 February 2019

Copyright: 2003-2018,, Inc.

PubMed Search: Mediastinum cytopathology germ cell tumors[TI]

Gordon H. Yu, M.D.
Page views in 2018: 485
Page views in 2019 to date: 316
Cite this page: Yu G. Cytopathology competency assessment - germ cell tumors (GCTs). website. Accessed November 12th, 2019.
Medical knowledge, practice based learning and systems based practice
  1. Recognize the incidence of GCTs in the mediastinum
  2. Identify the most common GCT subtypes in the mediastinum
  3. Identify the most common mediastinal compartment in which GCTs occur
  4. Become familiar with the clinical presentation of GCTs, including elevation of serum markers in specific GCT subtypes
    1. Seminoma (germinoma)
      1. Recognize the male preponderance and expected age range for germinoma
      2. Become familiar with the typical cytomorphologic features of germinoma, including the characteristic smear background ("tigroid" appearance)
      3. Learn the differential diagnosis of this tumor and cytomorphologic features which may exclude other neoplasms
      4. Learn the utility of immunohistochemical stains in the differential diagnosis
    2. Teratomas
      1. Recognize the incidence of teratomas and their most common location within the mediastinum
      2. Identify the various types of tissue which may be present in teratoma and the primitive germ cell layers from which they are derived
      3. Learn the definition of immature teratoma and teratoma with a malignant component
      4. Become familiar with the cytomorphologic features of material which may be aspirated from teratoma
    3. Embryonal carcinoma
      1. Become familiar with the incidence, male preponderance and histologic appearance of embryonal carcinoma
      2. Recognize the differential diagnosis of embryonal carcinoma and the appropriate immunohistochemical stains which may be used in making a definitive diagnosis
    4. Yolk sac (endodermal sinus) tumor
      1. Recognize yolk sac tumor as the only malignant mediastinal GCT with female predominance
      2. Become familiar with the characteristic morphologic appearance of yolk sac tumor, particularly the classic findings of Schiller-Duval bodies and hyaline globules and the expected immunohistochemical staining pattern of this tumor
    5. Choriocarcinoma
      1. Recognize common presenting signs and symptoms of this tumor, based on its frequent production of human chorionic gonadotropin and its clinical behavior, in comparison to other GCTs of the mediastinum
      2. Become familiar with the FNA findings of this tumor, based on its characteristic histologic appearance
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