THE BIOLOGICAL AND CLINICAL-SIGNIFICANCE OF HCG-CONTAINING CELLS IN SEMINOMA

The morphological appearance, incidence and prognostic significance of human chorionic gonadotrophin (HCG)-containing cells in seminomas were examined in a retrospective series of 228 orchidectomy specimens, obtained between 1958-1972. Sections from each tumor were stained with hematoxylin and eosin (H and E) and immunocytochemically for HCG. In 33 (14.5%) of the tumors; HCG-containing cells were observed, but in only 12 were these recognized in an initial study of the H and E stained sections. HCG staining was seen predominantly in syncytiotrophoblastic giant cells and rarely in "mulberry" cells and mononuclear seminoma cells. Of the patients whose tumors included HCG-containing cells, 23% died of their disease within 2 yr of orchidectomy, compared with only 8% of the patients whose tumors lacked this feature. Immunocytochemical staining for HCG apparently should form part of the routine histological assessment of seminomas and that the presence of HCG-containing cells indicates a more aggressive disease.