Primary germ cell tumours of the mediastinum: A review with emphasis on diagnostic challenges

Histopathology. 2024 Jan;84(1):216-237. doi: 10.1111/his.15090. Epub 2023 Nov 23.

Abstract

This article will review current aspects of the histopathological, immunohistochemical and molecular analysis of primary mediastinal germ cell tumours (PMGCTs) as well as their aetiological, epidemiological, clinical and therapeutic features. PMGCTs represent an important differential diagnosis in the spectrum of mediastinal tumours, and their diagnosis is usually made on small tissue samples from core needle biopsies in combination with diagnostic imaging and serum tumour markers. As in lymphomas, a small biopsy is often the only viable tumour sample available from these patients, as they receive chemotherapy prior to eventual surgical resection. Pathologists therefore need to apply an efficient combination of immunohistochemical markers to confirm the diagnosis of a PMGCT and to exclude morphological mimics.

Keywords: germ cell tumour; haematological malignancy; isochromosome 12p; mediastinum; somatic-type malignancy.

Publication types

  • Review

MeSH terms

  • Humans
  • Lymphoma* / pathology
  • Mediastinal Neoplasms* / diagnosis
  • Mediastinal Neoplasms* / pathology
  • Mediastinum / pathology
  • Neoplasms, Germ Cell and Embryonal* / diagnosis
  • Neoplasms, Germ Cell and Embryonal* / pathology