ArticleModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc2016
High-level expression of divergent endodermal lineage markers in gonadal and extra-gonadal yolk sac tumors.
Article in Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Hepatic Yolk Sac Tumor: A Systematic Review of Presentation, Diagnosis, and Treatment.Journal of gastrointestinal cancer · 2025Pooled it
- Integrated Histopathologic and Targeted Genomic Characterization of Gastric Adenocarcinomas with Yolk Sac Tumor Differentiation.International journal of molecular sciences · 2026Article
- Primary prostatic yolk sac tumor: A rare case report and literature review.Urology case reports · 2026Article
- Metastatic epidural spinal cord compression from testicular yolk sac tumor: case report and literature review.Journal of spine surgery (Hong Kong) · 2024Article
- Cases of Yolk sac tumor associated with gynecological malignant tumor.BMC women's health · 2023Article
- Stem Cell Origin of Cancer: Implications of Oncogenesis Recapitulating Embryogenesis in Cancer Care.Cancers · 2023Article
- Vaginal yolk sac tumors in infants and children: A case report and literature review.Oncology letters · 2023Article
- [Current view on testicular tumors from a developmental biological perspective : Important biomarkers and molecular pathological investigations].Pathologie (Heidelberg, Germany) · 2022Review
- Clinicopathologic Characteristics and Survival of Patients with Rare Malignant Ovarian Yolk Sac Tumors: A Population-based Analysis.Current medical science · 2021Article
- American Registry of Pathology Expert Opinions: Evaluation of poorly differentiated malignant neoplasms on limited samples - Gastrointestinal mucosal biopsies.Annals of diagnostic pathology · 2020Review
- [Diagnosis and treatment of seven primary mediastinal yolk sac tumors].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2019Article
- Primary yolk sac tumour of the prostate mimicking small round blue cell tumour.Current oncology (Toronto, Ont.) · 2019Article
- High-dose chemotherapy and stem-cell rescue for salvage therapy for relapsed malignant mixed ovarian germ cell tumor: A case report.Gynecologic oncology reports · 2017Article
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3 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
Yolk sac tumors occur at both gonadal and extra-gonadal sites. A recent case of ovarian endometrioid-pattern yolk sac tumor with strong diffuse expression of TTF-1 illustrated the potential for misdiagnosis due to divergent expression of endodermal lineage markers. The aim of this study was to investigate the expression of four divergent endodermal lineage markers, TTF-1, CDX2, Hep Par 1, and Napsin A, in gonadal and extra-gonadal yolk sac tumors of differing age, sex, and location (excluding foci of overt hepatoid differentiation). We identified 26 cases (5 ovarian, 15 testicular, and 6 extra-gonadal) containing yolk sac tumor as identified by typical histology and confirmed by positive immunohistochemical staining for alpha-fetoprotein and glypican-3. Mixed or ambiguous foci were confirmed by immunohistochemistry (SALL4 positive and Oct-4 negative). The relative proportion of three histologic patterns: reticular/cystic, solid/myxoid, and glandular was estimated. Percent positivity for the four divergent endodermal lineage markers was compared within yolk sac tumor areas according to site, age group, and histologic pattern. High-level (>25%) staining for one or more divergent endodermal lineage markers was seen in eleven cases: Hep Par 1 in seven cases, all post-pubertal, TTF-1 in four cases, two ovarian and two extra-gonadal, and CDX2 in three cases, with no age or site predilection. No case highly expressed all three divergent endodermal lineage markers, but four co-expressed high levels of two markers: two ovarian yolk sac tumors with TTF-1 and Hep Par 1, one testicular yolk sac tumor with CDX2 and Hep Par 1, and one extra-gonadal yolk sac tumors with TTF-1 and CDX2. While no absolute correlation of high-level divergent endodermal lineage marker expression with histologic subtype was observed, TTF-1 and CDX2 expression was predominantly seen in reticular/cystic and glandular areas while Hep Par 1 was most frequent in myxoid/solid and glandular areas.
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