A 30-year-old woman has a 4 cm ovarian mass. Histology shows sheets of uniform cells with central round nuclei, prominent nucleoli, and clear cytoplasm. The cells are arranged in nests separated by fibrous septa with dense lymphoplasmacytic infiltrate. IHC shows PLAP and OCT3/4 positive, EMA negative. Which is the correct diagnosis?
- A Clear cell carcinoma
- B Dysgerminoma ✓
- C Yolk sac tumor
- D Krukenberg tumor
Correct answer: B. Dysgerminoma
Explanation
Dysgerminoma is the female counterpart of testicular seminoma. It shows sheets of uniform cells with clear cytoplasm, fibrous septa with lymphocytes, and PLAP/OCT3/4 positivity. It is highly radiosensitive and chemosensitive with excellent prognosis. Clear cell carcinoma is EMA positive and occurs in older women. Yolk sac tumor shows Schiller-Duval bodies and AFP positivity. Krukenberg shows signet ring cells.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.