title: Do Histopathologic Variables Affect the Reporting of Lymphovascular Invasion in Testicular Germ Cell Tumors?
abstract: OBJECTIVE
  Identification of lymphovascular invasion (LVI) in testicular germ cell tumors (GCTs) is a challenging yet important aspect of cancer staging that can alter therapeutic management. Our study aimed to identify pathologic features that affect the reporting of LVI.
  
  
  METHODS
  Pathology report and slide review of orchiectomies performed at our institution between 2007 and 2013 for testicular GCTs were performed.
  
  
  RESULTS
  Seminomas grossed by residents had a higher rate of reported LVI compared with specimens grossed by pathology assistants (46% vs 15%). Tumor displacement artifact was more frequent in seminomas vs mixed GCTs (60% vs 38%). LVI concordance was high upon review (κ = 0.77), with displacement artifact present in all discrepancies. Tumor emboli from cases reported to have LVI had a higher frequency of tumor cohesiveness, smooth contours, and adherence to vessel walls compared with tumor emboli that were considered pseudo-LVI. Presence of fibrin and RBCs were features found at a similar frequency in emboli that were reported as LVI compared with those deemed artifactual.
  
  
  CONCLUSIONS
  Grosser type, tumor subtype, tumor displacement artifact, and characteristics of tumor emboli are pathologic features that affect the interpretation of LVI in testicular GCTs. Pathologists should be aware of these variables to more accurately diagnose LVI.
authors.affiliation: From the Department of Pathology, The Ohio State University Medical Center, Columbus.
authors.forename: Bryce L
authors.initials: BL
authors.lastname: French
authors.affiliation: From the Department of Pathology, The Ohio State University Medical Center, Columbus. debra.zynger@osumc.edu.
authors.forename: Debra L
authors.initials: DL
authors.lastname: Zynger
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004502:Education, Medical, Continuing; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology*; D009360:Neoplastic Cells, Circulating / Q000473:pathology; D009919:Orchiectomy; D011379:Prognosis; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000473:pathology*; D013737:Testis / Q000473:pathology*
keywords: Butter; Germ cell tumor; Grosser; Histopathologic; Lymphovascular invasion; Prospector; Testicle; Tumor displacement