Lesional-mixture of large cells and robust lymphocytic inflammation. No discrete granuloma. some old hemorrhage. Favour germinoma. Need another biopsy for pernanents.
Sections show a lesional process characterized by a mixture of cells with aggregates and small groups of larger tumour cells characterized as somewhat polygonal cells with prominent nuclei and nucleoli. These are interningled and surrounded by abundant likely reactive smaller mononuclear cells chiefly lymphocytes with probably some admixed histiocytes or macrophages. There is no discrete granuloma formation. There is no tissue necrosis. Eosinophils are not evident.
With the immunohistochemistry, there is multifocal positivity throughout the lesion for CD117(CKIT) in the larger tumour cells described. A similar pattern is seen for placental alkaline phosphatase. Alpha-fetoprotein and beta HCG are immunonegative. There is very robust T-lymphocytic reactive inflammatory process highlighted with CD3 immunopositivity. Ki-67 shows a signigicant proliferation and CD68 also shows a robust intermingled macrophage inflammatory reaction.