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Review
. 2022 Oct;81(4):459-466.
doi: 10.1111/his.14675. Epub 2022 Jul 1.

An introduction to the WHO 5th edition 2022 classification of testicular tumours

Daniel M Berney  1 , Ian Cree  2 , Vishal Rao  3 , Holger Moch  4 , John R Srigley  5 , Toyonori Tsuzuki  6 , Mahul B Amin  7   8 , Eva M Comperat  9   10 , Arndt Hartmann  11 , Santosh Menon  12 , George J Netto  13 , Mark A Rubin  14 , Samra Turajlic  15 , Maria R Raspollini  16 , Satish K Tickoo  17
Affiliations
Review

An introduction to the WHO 5th edition 2022 classification of testicular tumours

Daniel M Berney et al. Histopathology. 2022 Oct.

Abstract

The 5th edition of the World Health Organisation Blue Book was published recently and includes a comprehensive update on testicular tumours. This builds upon the work of the 4th edition, retaining its structure and main nomenclature, including the use of the term 'germ cell neoplasia in situ' (GCNIS) for the pre-invasive lesion of most germ cell tumours and division from those not derived from GCNIS. While there have been important developments in understanding the molecular underpinnings of testicular cancer, this updated classification paradigm and approach remains rooted in morphology. Nomenclature changes include replacement of the term 'primitive neuroectodermal tumour' by 'embryonic neuroectodermal tumour' based on the non-specificity of the former term and to separate these tumours clearly from Ewing sarcoma. Seminoma is placed in a germinoma family of tumours emphasising relation to those tumours at other sites. Criteria for the diagnosis of 'teratoma with somatic transformation' have been modified to not include variable field size assessments. The word 'carcinoid' has been changed to 'neuroendocrine tumour', with most examples in the testis now classified as 'prepubertal type testicular neuroendocrine tumour'. For sex cord-stromal tumours, the use of mitotic counts per high-power field has been changed to per mm2 for malignancy assessments, and the new entities, 'signet ring stromal tumour' and 'myoid gonadal stromal tumour', are defined. Well-differentiated papillary mesothelial tumour has now been defined as tumour type with a favourable prognosis. Sertoliform cystadenoma has been removed as an entity from testicular adnexal tumours and placed with Sertoli cell tumours.

Keywords: Germ Cell Tumour; WHO; classification; teratoma; testis.

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Figures

Figure 1
Figure 1
Seminoma with a syncytiotrophoblastic cell. Seminomas are now placed in the germinoma family. [Colour figure can be viewed at wileyonlinelibrary.com]
Figure 2
Figure 2
Testis showing a teratoma with somatic type malignant transformation to nephroblastoma. [Colour figure can be viewed at wileyonlinelibrary.com]
Figure 3
Figure 3
Embryonic neuroectodermal tumour. [Colour figure can be viewed at wileyonlinelibrary.com]
Figure 4
Figure 4
A pre‐pubertal type teratoma with and area of low‐grade neuroendocrine tumour. [Colour figure can be viewed at wileyonlinelibrary.com]
Figure 5
Figure 5
Pre‐pubertal type testicular neuroectodermal tumour. [Colour figure can be viewed at wileyonlinelibrary.com]
Figure 6
Figure 6
Signet ring stromal tumour. [Colour figure can be viewed at wileyonlinelibrary.com]
Figure 7
Figure 7
Myoid gonadal stromal tumour. [Colour figure can be viewed at wileyonlinelibrary.com]
See this image and copyright information in PMC

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