A 19-year-old woman has a unilateral solid ovarian mass. Serum LDH is markedly elevated while CA-125, AFP and beta-hCG are normal. Microscopy shows sheets of uniform round cells with central nuclei and clear cytoplasm, infiltrated by mature lymphocytes. Which marker will be positive on immunohistochemistry?

• A Chromogranin and synaptophysin
• B Inhibin and calretinin
• C Glypican-3 and SALL4 with AFP production
• D OCT3/4 and CD117 ✓

Explanation

Dysgerminoma is the most common malignant ovarian germ cell tumor and characteristically secretes LDH rather than AFP or beta-hCG. Histology shows uniform primitive germ cells arranged in sheets or nests separated by lymphocyte-rich fibrous septa. The tumor cells express OCT3/4, PLAP, SALL4 and CD117 (KIT). Inhibin marks sex cord-stromal tumors and glypican-3 with AFP marks yolk sac tumor.

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.