Germinoma with a granulomatous reaction. Problems of differential diagnosis.
The patient was a 6 year-old girl with a progressive loss of visual acuity. Magnetic resonance imaging showed a suprasellar mass lesion with enhanced gadolinium which was resected. Histopathological study showed a remarkable granulomatous reaction, but a diagnosis was difficult. However, immunohistochemical study showed a few cells that were positive for placental alkaline phosphatase and it was diagnosed as germinoma. Intracranial germinoma with a remarkable granulomatous reaction is rare. However, when germinoma is suspected clinically, an immunohistochemical study is able to identify germinoma even if granulomatous disease is diagnosed histopathologically.
Konno
S
S
Department of Neurosurgery, Kitasato University School of Medicine, Sagamihara, Kanagawa, Japan.
Oka
H
H
Utsuki
S
S
Kondou
K
K
Tanaka
S
S
Fujii
K
K
Yagishita
S
S
D000469:Alkaline Phosphatase; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D002648:Child; D002945:Cisplatin / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D058851:GPI-Linked Proteins; D018237:Germinoma / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D006099:Granuloma / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D007527:Isoenzymes / Q000378:metabolism; D008279:Magnetic Resonance Imaging
D000970:Antineoplastic Agents; D058851:GPI-Linked Proteins; D007527:Isoenzymes; D005047:Etoposide; D000469:Alkaline Phosphatase; C019839:alkaline phosphatase, placental; D002945:Cisplatin