eISSN: 2084-9869
ISSN: 1233-9687
Polish Journal of Pathology
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SCImago Journal & Country Rank
2/2022
vol. 73
 
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abstract:
Original paper

Diagnostically misleading aberrant terminal deoxynucleotidyl transferase expression in germ cell tumors

Rafał Pęksa
1
,
Michał Kunc
1
,
Michał Bieńkowski
1
,
Marta Popęda
1
,
Wojciech Biernat
1

1.
Department of Pathomorphology, Medical University of Gdańsk, Gdańsk, Poland
Pol J Pathol 2022; 73 (2): 159-165
Online publish date: 2022/10/10
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Terminal deoxynucleotidyl transferase (TdT) is a unique type of DNA polymerase predominantly expressed in precursor lymphoid cells and acute lymphoblastic leukemia. It participates in the junctional diversity of T-cell receptors and immunoglobulins. Recently, aberrant TdT expression was found in seminomas. Here, we evaluated the expression of TdT in our cohort of germ cell tumors (GCTs) with two anti-TdT antibody clones.

We included 173 cases of testicular GCTs, 5 ovarian dysgerminomas, and one gonadoblastoma in the study. Tissue microarrays containing representative tumor samples were constructed and subsequently stained with anti-TdT monoclonal rabbit antibody EP266 (Dako) and TdT rabbit polyclonal antibody (Cell Marque).

Expression was assessed with the H-score. No specific nuclear reaction was observed for the polyclonal anti-TdT antibody. The H-score values varied between the histological subtypes for the EP266 antibody. Positive nuclear staining was consistently seen in germ cell neoplasia in situ, seminoma, dysgerminoma, and embryonal carcinoma. Pure tumors had higher TdT H-scores than the mixed ones. Teratomas, yolk sac tumors, and choriocarcinomas were almost uniformly negative.

Our study confirms that aberrant expression of TdT by testicular and ovarian GCTs exemplifies a potential diagnostic pitfall in histopathological diagnostics.
keywords:

terminal deoxynucleotidyl transferase, germ cell tumor, testis, immunohistochemistry, pathology, seminoma, embryonal carcinoma

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