GPR: 2021 - Week 01

From MGH Learn Pathology

Clinical history

29 year old male with firm, irregular testicular mass.


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Embryonal carcinoma
  • 15-35 y/o (generally younger population than seminoma)
  • 2nd most common pure testicular germ cell neoplasm, but more often a component of malignant mixed germ cell tumor
  • fleshy gray and white with variegated appearance
  • prominent necrosis and hemorrhage




  • 35-45 y/o
  • most common malignant testicular neoplasm
  • Well circumscribed and homogeneous with or without lobulation
  • gray-white, tan, creamy, often bulging cut surface
  • usually no hemorrhage or necrosis



Leydig cell tumor

  • 2 peaks: 5-10 y/o and 30-35 y/o
  • most common sex cord-stromal testicular neoplasm, but rare overall (1-3% of total testicular neoplasms)
  • well-circumscribed, intraparenchymal nodule
  • yellow-tan homogeneous or lobulated cut surface; lobules may be separated by fibrous bands
  • necrosis and hemorrhage are uncommon



Diffuse large B-cell lymphoma (primary testicular lymphoma)

  • most common testicular neoplasm in >60 y/o
  • rare, 1% of all non-Hodgkins lymphomas in the US
  • DLBCL is most common primary testicular lymphoma
  • large (median: ~6 cm), fleshy, homogeneous mass
  • Jakob Moran
  • Himanshu Gunderia
  • Derek Kingman


Chan Y. Cheah, Andrew Wirth, John F. Seymour; Primary testicular lymphoma. Blood 2014; 123 (4): 486–493. doi:

This week's Gross Pathology Roundup was presented by Miranda Machacek MD, PhD on 2021-01-04.