Table 1.

List of Differential Diagnosis of Steroid Cell Tumor, NOS, based on Histolpathological

Feature.

No Diagnosis Common Different feature(s) Picture

Feature(s)
1. Stromal Steroid Located within ovarian
luteoma producing stroma, associated with
ovarian tumor stromal hyperthecosis,
with symptoms shows degenerative
of virilization pseudovascular spaces.
Common in elder patients1

Tumor arranged in nests, separated

by pseudavascular spaces.2
2 Leydig cell Steroid Hilar location, cytoplasmic
tumor producing Reinke crystals, associated
ovarian tumor with Leydig cell
with symptoms hyperplasia.2, 3
of virilization

Tumor shows intracytoplasmic

Reinke cystals4
3 Pregnancy Steroid Pregnancy, multifocal
luteoma producing (50%), bilateral (one-
ovarian tumor third), regress after
with symptoms pregnancy. There is no
of virilization pale lipid rich cells.5

The typical follicle like spaces in

pregnancy luteoma.6
4 Oxyphillic Abundant True gland formation,
endometrio eosnophilic squamous/ mucinous
id cytoplasm differentiation,
carcinoma adenofibromatous or
endometriosis background.
IHC: CK7 and EMA.2

Endometrioid carcinoma with

abundant eosinophilic cytoplasm.7
5 Oxyphilic Abundant Tubulocystic/ papillary
clear cell eosnophilic structure, lined cuboidal,
carcinoma cytoplasm hobnail, flattened cells,
nests and sheets cells with
abundant clear cytoplasm
and adenofibromatous
background.2, 8

Tumor cells shows scanty to

moderated amount of eosinophilic
cytoplasm, no cytoplasmic
clearing.9
6 Hepatoid Diffuse growth Associated with elevated
yolk sac of exophilic AFP. Focal gland
tumor cells. formation, PAS positive
hyaline globules. Areas of
conventional yolk sac
tumor.
IHC: AFP and HepPar1.2,
10

Tumor cells with glandular

elements.11
7 Metastatic Resembles other hepatoid
hepatocellu yolk sac tumor. Clinical
lar history and imaging are
carcinoma helpful.2

Tumor cells arranged in sinusoidal

pattern, with moderate n/c ratio,
vesicular and centrally located
nuclei, and abundant eosinophilic
cytoplasms.12
8 Malignat Cells with Higher mitotic activity and
melanoma abundant overt malignant cytologic
(primary or eosinophilic feature. Contains melanin
secondary) cytoplasm. pigment.
Sometimes IHC: Melan-A, S100
contain pigment protein, HMB-45, Mart-113

Tumor cells containing pigment.13

9 Clear cell Tumor cells with See oxyphilic clear cell
carcinoma abundant clear carcinoma
cytoplasm

Tumor shows clear cytoplasm. 14

10 Metastatic Diffuse growth Contain glycogen.
renal cell of clear cells, IHC: RCC.2
carcinoma delicate vascular
networks,
express CD10
and vimentin,
contain
intracellular lipid

Tumor arranged in nests separated

by vascular septa and tubules.15
11 Metastatic Morphologically Clinical history and
adrenocorti identical radiographic correlation.2
cal
carcinoma

Tumor with increase mitotic

figures.16
12 Lipid-rich Similar Presence of estrogenic
Sertoli cell morphology and manifestations as well as a
carcinoma immunoprofile solid tubular growth
pattern.2

Tumor cells shows lipid storage,

obscuring tubular architecture. 17
13 Paragang- Bland oxyphilic Sustentacular cells.
lioma cells with nested IHC: S100 (sustantecular
growth pattern. cells), neuroendocrine
Focal staining for markers.18
inhibin and
calretinin

Tumor shows zellballen

arrangement with clear granular
cytoplasm.18

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