LEYDIG CELL TUMOR – TESTIS

LEYDIG CELL TUMOR – TESTIS

• More common in adults

• These tumors are usually associated with 

  • Gynecomastia

  • Klinefelters syndrome

  • Cryptorchisdism

• Gross – Cut surface is homogenous, solid yellow to brown

• Microscopically –

  • Tumor cells large polygonal with abundant eosinophilic cytoplasm or lipid laden cytoplasm

  • Reinke crystals are seen in the tumor cells in 80% of cases

• Immunohistochemistry 

  • Positive for Inhibin, Calretinin and Melan A

• Differential diagnosis 

  • Leydig cell hyperplasia – Leydig cell tumor presents as nodule without semniferous tubules but Leydig cells hyperplasia are bilateral, multifocal and extend between the tubules

• Prognosis – 

  • 90% of Leydig cell tumor are benign

  • Features favoring malignancy are

    • Size – >5cms

    • Cytologic atypia

    • Increased mitotic activity

    • Necrosis

    • Vascular invasion.