Neoplasia: seminoma immunophenotype: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Neoplasia: seminoma immunophenotype

Sample item

A 30-year-old man has a painless testicular mass. The orchidectomy specimen shows sheets of uniform round cells with clear cytoplasm and distinct borders, divided by fibrous septa containing lymphocytes. Serum AFP is normal. Which immunohistochemical profile confirms the diagnosis and distinguishes the tumour from embryonal carcinoma?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. OCT3/4 and CD117 positive, CD30 negative

Classical seminoma expresses the germ cell markers OCT3/4, placental alkaline phosphatase and CD117 (c-KIT), and is generally CD30 and cytokeratin negative. Embryonal carcinoma is CD30 and cytokeratin positive, and it also expresses OCT3/4. Yolk sac tumour expresses AFP and glypican-3. A normal AFP supports pure seminoma, as any raised AFP implies a non-seminomatous component.

Option by option

  • A. CD30 and cytokeratin positive, OCT3/4 positive

    CD30 and cytokeratin positivity are the features of embryonal carcinoma.

  • B. OCT3/4 and CD117 positive, CD30 negative (correct)

    OCT3/4 and CD117 with absent CD30 matches seminoma.

  • C. Chromogranin and synaptophysin positive, OCT3/4 negative

    Neuroendocrine markers in an OCT3/4-negative tumour suggest a neuroendocrine neoplasm.

  • D. Glypican-3 and AFP positive, CD117 negative

    AFP and glypican-3 positivity point to yolk sac tumour.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is B, OCT3/4 and CD117 positive, CD30 negative. Classical seminoma expresses the germ cell markers OCT3/4, placental alkaline phosphatase and CD117 (c-KIT), and is generally CD30 and cytokeratin negative.

Why is "CD30 and cytokeratin positive, OCT3/4 positive" not the answer?

CD30 and cytokeratin positivity are the features of embryonal carcinoma.

Why is "Chromogranin and synaptophysin positive, OCT3/4 negative" not the answer?

Neuroendocrine markers in an OCT3/4-negative tumour suggest a neuroendocrine neoplasm.

Why is "Glypican-3 and AFP positive, CD117 negative" not the answer?

AFP and glypican-3 positivity point to yolk sac tumour.

What concept does this question test?

It tests Neoplasia: seminoma immunophenotype in Pathology. Embryonal carcinoma is CD30 and cytokeratin positive, and it also expresses OCT3/4. Yolk sac tumour expresses AFP and glypican-3. A normal AFP supports pure seminoma, as any raised AFP implies a non-seminomatous component.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neoplasia: seminoma immunophenotype?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.