Histologic factors affecting prognosis of pure seminoma of the testis

The outlook for patients with seminoma of the testis is generally favorable, with 75% surviving for as long as 17 yr after initial treatment. It has been suggested that the prognosis is improved in cases of seminoma showing a lymphoid and/or granulomatous reaction, and that this reaction indicates a response to some antigen on, or produced by, the tumor cells. The hypothesis of an autoimmune reaction has been analyzed in 65 patients with seminomas and the relation between the intensity of the infiltration and survival was found to be positive. However, additional confirmatory studies have not appeared. Therefore the clinical and histologic findings in 92 cases of pure seminoma of the testis were reviewed in relation to the presence and degree of fibrosis, necrosis, granulomatous and lymphocytic reactions, interstitial cell hyperplasia, and lymphatic and/or vascular invasion associated with the primary tumor. No relation between any of the histologic factors studied and survival was established.