PMC6545753_01
(a) Sonographic appearance of the adult granulosa cell tumor in the 22-year-old patient. Note the lobulated but well circumscribed shape and homogeneous hypoechoic appearance. (b) The same patient, color-coded duplex sonography showing duplex signals within the hypoechoic lesion.
CRIU2019-7156154.001.jpg
PMC6545753_01_CRIU2019-7156154.001.jpg
fig1
Scrotal sonography revealed a 1 cm sized lobulated hypoechoic lesion at the cranial pole of the left testis (Figure 1(a)) showing intense color duplex signals within the lesion (Figure 1(b)).
(a) Histological section of the neoplasm, hematoxylin-eosin stain. Well demarcated rim of the testicular neoplasm, no clear encapsulation. Normal testicular parenchyma, upper part of image. 10x magnification. (b) Histological section of the neoplasm. The tumor cells have scant cytoplasm and elongated nuclei with numerous grooves (arrow). Hematoxylin-eosin stain, magnification x20.
CRIU2019-7156154.002.jpg
PMC6545753_01_CRIU2019-7156154.002.jpg
fig2
Pathohistological analysis showed a well demarcated solid neoplasm of 8 mm in size (Figure 2(a)). Many of the cells had large nuclei with many of them having a grooved shape mirroring the appearance of coffee beans (Figure 2(b)).
Histological section of the tumor. Adult granulosa cell tumor with microfollicular pattern. Call-Exner body: coffee bean-like tumor cells with groove core notches surrounding glandular cavities containing eosinophilic material and tumor cells detached from the dressing (arrows). Hematoxylin-eosin stain, 10x magnification.
CRIU2019-7156154.003.jpg
PMC6545753_01_CRIU2019-7156154.003.jpg
fig3
The growth pattern was solid in most parts of the neoplasm but in some areas microfollicular structures prevailed resembling Call-Exner bodies (Figure 3).
Immunohistological stain of calretinin. All neoplastic cells stain positive for calretinin, 10x magnification.
CRIU2019-7156154.004.jpg
PMC6545753_01_CRIU2019-7156154.004.jpg
fig4
Immunohistochemical workup revealed positive staining of inhibin, vimentin, and calretinin (Figure 4) and negative staining for Oct 4 and chromogranin A.