A 19-year-old woman presents with amenorrhoea, deepening voice, temporal hair recession, and clitoromegaly. Testosterone is markedly elevated while dehydroepiandrosterone sulfate is normal. Ultrasound shows a 7 cm solid left ovarian mass. Histology after excision shows tubules lined by Sertoli cells admixed with clusters of Leydig cells containing lipid. Which finding, if present, would confirm the Leydig cell component?

• A Reinke crystals ✓
• B Schiller-Duval bodies
• C Call-Exner bodies
• D Psammoma bodies

Explanation

Sertoli-Leydig cell tumour (androblastoma) is a sex cord-stromal tumour of young women that secretes androgens causing defeminisation then virilisation, with normal DHEA-S pointing to an ovarian rather than adrenal source. Reinke crystals are pathognomonic of Leydig cells. Call-Exner bodies belong to granulosa cell tumour, Schiller-Duval bodies to yolk sac tumour, and psammoma bodies to serous lesions.

Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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