Primary neuroectodermal tumour of the testis

A 51-year-old male presented with metastasis of a small cell carcinoma of unknown origin in a right inguinal lymph node. Clinical and laboratory studies failed to locate the primary tumour. After three years, a swelling appeared in the right testis, which was removed. Histological examination revealed a proliferation of small tumour cells forming irregular masses or nests that occupied most of the testicular parenchyma. At the periphery of the testicular parenchyma a few seminiferous tubules could be observed, showing a low and incomplete seminiferous epithelium and numerous tumour cells in the lumen. Most of the tumour cells showed a euchromatic nucleus with small nucleoli and scanty cytoplasm. Among these cells, larger binucleate or trinucleate cells as well as small cells with pyknotic nuclei were also observed. Mitoses were numerous. Electron microscopy revealed some tumour cells with 80 to 100 nm vesicles containing electron-dense granules. Some cells displayed dendrite-like prolongations with numerous intermediate filaments and electron-dense vesicles. This tumour is compatible with a primary neuroectodermal tumour of the testis.

Presence of ribonucleoproteins and basic proteins in the nuage and intermitochondrial bars of human spermatogonia

Ultrastructural cytochemical study of the nuage in the human adult testis revealed that this structure was a cytoplasmic fine fibrillar electron-dense mass, similar to the chromatoid body of spermatids, in all spermatogonial types and spermatocytes. The nuage was often observed in relation with the nucleus or mitochondria. Cytochemical techniques showed staining affinity of the nuage for both ethanolic phosphotungstic acid and ethylene diamine tetra-acetic acid. The intermitochondrial bars were also stained with the two procedures. The results suggest that the nuage originates from the nucleus and migrates to the cytoplasm through nuclear pores, giving rise to the intermitochondrial bars.

Radiation-induced osteochondroma-like lesion in young rat radius

To investigate the effects of radiation on the perichondrial groove of Ranvier in osteochondroma development, the external surface of the distal growth plate of the radius in both forelimbs of 30 ten-day-old rats was exposed to a single low dose of radiation (150 r), which was focused on the perichondrial groove. This induced the formation of a chondrocyte nest at the proximal external edge of the growth plate (five to nine days after irradiation). With advancing longitudinal growth of the bone, the chondrocyte nest occupied a diaphyseal position. At nine to 11 days the chondrocyte nest underwent endochondral ossification. At 13-15 days, this osteochondroma-like lesion began to regress with the disappearance of the chondrocyte nest. After 19-21 days, only an irregularly thickened cortical bone remains at the osteochondroma site. Although the possible role of the growth plate subjacent to the irradiated perichondrial groove must be taken into account, the continuity between the perichondrial groove and the osteochondroma, which is separated from the growth plate by the periosteal ring (bone bark), suggests that the perichondrial groove was involved in osteochondroma-like lesion development.

Quantitative and ultrastructural study of Leydig cells in Klinefelter's syndrome

This ultrastructural and quantitative study of Leydig cells in Klinefelter's syndrome has been performed using the entire testes obtained from four autopsies plus testicular biopsies from 20 patients. The total Leydig cell volume per testis in Klinefelter's syndrome was similar to that of control testes. However, the total number of Leydig cells per testis was significantly lower in the patients with Klinefelter's syndrome than in the controls. This may be attributed to the Leydig cell hypertrophy that these patients underwent. In patients with Klinefelter's syndrome the average volume of each Leydig cell was significantly higher than that of the controls. Electron microscopic findings revealed that besides ultrastructurally normal Leydig cells there were three other morphologically abnormal Leydig cell types: abnormally differentiated cells; multivacuolated cells; and immature Leydig cells. The ultrastructurally normal Leydig cells were probably the cells principally responsible for testosterone biosynthesis in these patients, whereas the other Leydig cell types were probably barely or not at all functional. The hypertrophy showed by the ultrastructurally normal Leydig cells may be interpreted as an attempt to increase testosterone production.

Ultrastructural changes in Sertoli cells in ageing humans

Ultrastructural study of seminiferous tubules in ageing men revealed a varying degree of spermatogenetic arrest associated with changes in the Sertoli cells. Approximately half of the Sertoli cells showed a normal mature nuclear appearance although the cytoplasm was altered morphologically. These cells were classified as containing abundant lipid droplets (30%), containing large cytoplasmic vacuoles filled with an amorphous material similar to that in the tubule lumen and surrounded by junctional specializations (8%), multinucleated Sertoli cells (4%), or Sertoli cells with numerous mitochondria displaying tubular cristae (2%). The remaining 7% of Sertoli cells had an immature nuclear appearance and sparse development of the cytoplasmic organelles; these cells probably represent dedifferentiated Sertoli cells. Although individual differences were marked, a correlation between the increase in gonadotrophin levels and changes in both germ cell development and Sertoli cell structure was observed.

Testis, epididymis, and spermatic cord in elderly men. Correlation of angiographic and histologic studies with systemic arteriosclerosis

Autopsy specimens of the testes, epididymides, and spermatic cords from 20 adult young and 60 elderly men were studied by angiographic and histologic techniques. Testicular alterations in elderly men were correlated to the degree of aortic atheromatosis. Elderly men without manifest atheromatosis showed no lesions. Elderly men with slight atheromatosis showed a spiculated outline of the testicular artery and intraparenchymatous zones with scarce filling of small arteries. These zones exhibited peritubular and interstitial fibrosis. Elderly men with severe atheromatosis showed large zones of the testicular parenchyma with scarce filling of centrifugal and centripetal arteries that exhibited fibrosis of the tunica intima and lumen reduction; the testicular parenchyma appeared fibrosed with sclerosed tubules. Epididymal lesions were parallel to testicular lesions. These results suggest that systemic arteriosclerosis is involved in the decline of testicular function with age.

Histologic lesions in undescended ectopic obstructed testes

Testicular biopsies and hormone studies have been carried out on 229 children with unilateral (181) or bilateral (48) undescended ectopic obstructed testes not associated with other pathologic conditions. With regard to the histologic lesions, the obstructed testes may be classified into four types: (1) testes with minimal lesions (40.1%), showing slight reduction in both mean tubular diameter (MTD) and tubular fertility index (TFI); (2) testes with marked germinal hypoplasia (33.6%), showing slight or marked reduction in MTD and marked reduction in TFI; (3) testes with diffuse tubular hypoplasia (19.1%), showing severe reduction in MTD, marked or severe germinal hypoplasia, and normal or decreased Sertoli cell number per transverse tubular section (SCI); and (4) testes with Sertoli cell hyperplasia (7.2%), showing slightly decreased MTD, marked or severe germinal hypoplasia, and marked increased in SCI. These lesions are similar to those found in cryptorchid testes, although the proportion of testes with type III and IV lesions (the most severe) is lower than in cryptorchid testes. Hormone assays revealed normal basal gonadotropin and testosterone levels. The response of gonadotropins to gonadotropin-releasing hormone stimulation and the response of testosterone to human chorionic gonadotropin stimulation were normal or slightly reduced.

Malakoplakia of the maxillary sinus

The first case of malakoplakia in the nasal cavities is reported. The patient, a 21-year-old man, presented a polypoid formation in the left maxillary sinus that was removed and studied by light and electron microscopy. The polypoid formation consisted of pseudostratified epithelium surrounding a central myxoid tissue which contained fibroblasts, histiocytes, and small inflammatory infiltrates. The most relevant features were histiocyte accumulations containing 1 to 5-microns diameter granules which displayed a concentric multilayered configuration. Ultrastructural findings revealed three types of lysosomes within the histiocyte cytoplasm: phagolysosomes, intermediate bodies, and Michaelis-Gutmann bodies. Septate junctions between lysosomes were frequent. The etiopathogenesis of this lesion is discussed.

Cystic intra-abdominal testicular torsion in an infant

We report on a 3-month-old infant with cystic intra-abdominal testicular torsion. He presented with abdominal distension and pain. Physical examination showed a movable, well delineated mass in the right iliac and lumbar fossae. Exploration revealed that the mass was connected to the abdominal aorta by a thin vascular cord that was twisted before reaching the mass. The histological study showed that the mass corresponded to a testis with cystic formations. The testicular parenchyma was necrotized, although isolated seminiferous tubules were found. The cystic cavities were filled by hematic and necrotic material, and exhibited no epithelial lining. A fibrous layer in continuity with interstitial hemorrhage surrounded the cysts. The twisted vascular cord corresponded to a spermatic cord with dilated pampiniform plexus veins. The differential diagnosis and the etiopathogenesis of the lesion are discussed.

Multivacuolated cells in human cartilage canals

Light and electron microscopic examination of cartilage canals in 39 infants (from fetuses to 2 years of age) revealed the presence of multivacuolated cells in the connective tissue of the canals. These cells showed an irregular and electron-dense nucleus and cytoplasm; the latter was almost filled by large, irregular, membrane-bound vacuoles without or with hardly apparent content. Histochemistry revealed a weakly positive stain with periodic-acid-Schiff, oil-red-o and muramidase techniques in these cells which seem to be degenerated macrophages.

Seminiferous tubule degeneration in human cryptorchid testes

Two types of degenerating seminiferous tubules were found in cryptorchid testes with Sertoli cell hyperplasia of children and adults: 1) tubules with central degeneration, and 2) tubules with total degeneration. Central degeneration begins with degenerative changes in germ cells that accumulate in the lumen of the seminiferous tubule. Some Sertoli cells may also be affected. Degenerated cells finally disappear, and the remaining tubule is composed of only a cuboidal epithelium, which consists mainly of Sertoli cells and occasional germ cells surrounding a wide lumen. Total degeneration is principally seen in tubules with severe germinal hypoplasia. All the seminiferous epithelium cells degenerate and lose their characteristic distribution, forming a disorganized Sertoli cell nodule surrounded by a thickened basement membrane. Lastly, Sertoli cells disintegrate, and the seminiferous epithelium disappears. Tubular degeneration might be related to the thickening of the basement membrane, which hinders metabolic interchange between the seminiferous epithelium and the interstitium.

Histogenesis of adenomatoid tumour associated to pseudofibromatous periorchitis in an infant with hydrocele

An 18-month-old infant with recurrent congenital hydrocele presented with a mass in the caput epididymis. The tumour and several fragments of the tunica vaginalis were removed and studied by light and electron microscopy. The tumour showed the characteristic histological pattern of an adenomatoid tumour of mesothelial origin. The histological appearance of the tunica vaginalis was not uniform; some areas resembled the adenomatoid tumour to the epididymis, others exhibited histological and ultrastructural features of a haemangioma, whilst elsewhere, the two patterns were intermingled. Finally, areas of pseudofibromatous periorchitis with vascular proliferation and slit-like structures lined by mesothelial cells were recognized. These features suggest that the adenomatoid tumour originated from a localized reactive process with inflammation and vascular proliferation enclosing occasional slit-like structures originating from the mesothelial lining of the tunica vaginalis. Subsequent regression of vascular proliferation and inflammatory infiltration and continued mesothelial proliferation would give rise to the typical mesothelial pattern of adenomatoid tumour.

Occurrence of primary spermatocytes in the infant and child testis

Light microscope and ultrastructural studies of normal infants and children testes revealed the presence of primary spermatocytes and occasional spermatids at 4, 8, 9, 11, 12 and 13 years of age, but not in all the boys of these ages. When they were found they appeared in both testes, but only in a 5-25% of the seminiferous tubules. These spermatocytes undergo degeneration or progress to abnormal spermatids which degenerate in turn. Spermatozoa were never found.

Morphological and histometric study of human spermatogonia from birth to the onset of puberty

Normal human testes obtained at autopsy from 99 male subjects whose ages ranged from a few days after birth to 13 years of age were studied by light and electron microscopy. Besides fetal and transitional spermatogonia, types Ap, Ad, and B spermatogonia, similar to those of the adult testis, are found. The number of spermatogonia per 10 cross sectioned tubules decreases slightly from birth (15.3 +/- 1.2) to 3 years of age (12.1 +/- 1.0), and increases afterwards until 8 years of age (28.2 +/- 2.6). After a brief decrease between the ages of 8 and 9, it increases markedly until 12-13 years of age (49.7 +/- 4.6). The number of fetal and transitional spermatogonia per 10 cross sectioned tubules is 5.3 +/- 0.5 at birth, and progressively decreases until they disappear at 6 years of age. The numbers of types Ap and Ad spermatogonia per 10 cross sectioned tubules are similar to one another from birth (about 5.2) to 12-13 years of age (about 21.5), except during the period between 4 and 10 years of age, when the number of type Ad spermatogonia slightly decreases with respect to that of type Ap. This period coincides with the appearance of type B spermatogonia, of which the number per 10 cross sectioned tubules progressively increases from 4 (0.2 +/- 0.02) to 12-13 years of age (6.7 +/- 0.5). All spermatogonial types are found either resting on the basal lamina or lying toward the lumen. Some of the basal spermatogonia, but mainly those occupying a more adluminal position, appear hypertrophic, bi- or trinucleated, or degenerated. These anomalous spermatogonia are more abundant at 3 and 8 years of age, prior to periods of spermatogonial proliferation. At these times spermatocytes and occasional spermatids are seen in some seminiferous tubules of some children.

Obstruction of the tubuli recti and ductuli efferentes by dilated veins in the testes of men with varicocele and its possible role in causing atrophy of the seminiferous tubules

Hormone measurements, spermiograms and testicular biopsies studies were performed in young with varicocele. In addition, the testes and epididymides of 27 adults with varicocele were obtained from autopsies. Light and electron microscopic examination of biopsy and autopsy specimens revealed two types of lesions in testes with varicocele: 1) a diffuse lesion consisting of abnormal spermatozoa and spermatid morphology and sloughing of immature spermatozoa and spermatid; 2) focal lesion, distributed irregularly throughout the testicular parenchyma, affecting several small groups of seminiferous tubules. Each of these groups corresponded to a testicular lobule and showed different degrees of tubular atrophy, so that the focal lesions were distributed in a mosaic pattern. The testicular interstitium showed dilated veins and venules, and progressive collagenization. Some testes showed dilated veins in the rete testis, which compressed several tubuli recti and caused tubular atrophy in the seminiferous tubules opening into these tubuli recti. Other testes showed dilated young veins among the ductuli efferentes, and the rete testis channels appeared to be dilated. Among the different etiological mechanisms which have been suggested to for testicular lesions in varicocele, tubular obstruction at the level of either the tubuli recti or the ductuli efferentes might be responsible for lesions leading to testicular atrophy.

Cystic dysplasia of the testis. Light and electron microscopic study of three cases

The testes of two premature newborns and a 9-year-old boy with cystic dysplasia were studied by light and electron microscopy. The histologic pattern of the three cases was similar, differing principally in the extension of the characteristic lesion. This consisted of multiple, anastomosing, irregular cystic spaces of varying sizes and shapes, separated by incomplete connective-tissue septa. The cysts were predominantly located in the mediastinum testis, and spread irregularly, displacing the testicular parenchyma, which was consequently compressed under the tunica albuginea. Electron microscopic examination revealed two types of epithelial cells (flattened and tall cells) lining the cystic spaces. These cells were similar to those lining the normal adult rete testis. Since the rete testis originates from the gonadal blastema, and the efferent ductules from the mesonephric ducts, an embryologic defect in the connection between both structures might be responsible for this lesion.

Effects of postpuberal gonadectomy on the neurosensorial epithelium of the vomeronasal organ in the rat

In the present report the effects of postpuberal gonadectomy on vomeronasal organ (VO) morphology were studied. Postpuberal gonadectomy induced in both male and female rats a decrement in the height of the epithelium and in the nuclear size of the bipolar neurons. These results show that the maintenance of neurosensorial normal morphology depend upon the activational effects of sex steroids.

Testicular lymphangiectasis in Noonan's syndrome

We describe a boy with testicular lymphangiectasis and Noonan's syndrome. Both testes showed seminiferous tubules with a reduced tubular diameter, containing few spermatogonia. The testicular interstitium exhibited a number of large, dilated lymphatic vessels forming irregular channels among the seminiferous tubules and surrounding them. Since there was no accompanying pathological condition to indicate an obstruction to the lymphatic flow at the level of the spermatic cord or in the regional lymph nodes, the abnormal development of testicular lymphatic vessels suggests a congenital malformation.

Infertility in adult males with retractile testes

The testicular biopsy, spermiogram, and hormonal assays performed on 23 infertile adult men with no other apparent cause of infertility than bilateral retractile testes are reported. Both luteinizing hormone and testosterone levels were normal, while follicle-stimulating hormone levels were normal or increased. The spermiogram showed oligozoospermia, asthenozoospermia, and severe teratospermia (tapering, amorphous, and immature forms). All the testicular specimens presented several focal histologic lesions, which were distributed in a mosaic pattern. The most frequent lesions were tubular lumen dilation, tubular diameter reduction, tunica propria thickening, tubular hyalinization, hypoplastic tubules, spermatocele, athrocytosis, vacuolation, or oncocytic transformation of Sertoli cell cytoplasm, maturation anomalies of spermatids, sloughing of immature spermatids, maturation arrests at the level of spermatids, primary spermatocytes or spermatogonia, germ cell hypoplasia, germ cell absence, peritubular and perivascular lymphocytic infiltrates, and venous angiectasis. These lesions seem to represent different progressive stages of tubular atrophy due to a temporary partial occlusion of the excretory ducts. This obstruction is probably caused by venous ectasia, which may be related to positional changes experienced by the testes during retraction.

Leydig cell types in primary testicular disorders

Ultrastructural study of testicular biopsy specimens from 67 adults with primary testicular disorders (Klinefelter's syndrome, XX male syndrome, Del Castillo's syndrome, and cryptorchidism) revealed the following four Leydig cell types: 1) normal or nearly normal Leydig cells with abundant smooth endoplasmic reticulum, mitochondria with tubular cristae, lipid droplets, and Reinke's crystals; 2) abnormally differentiated Leydig cells without either lipid droplets or Reinke's crystals but with altered mitochondria, concentric unfenestrated cisternae of smooth endoplasmic reticulum, and both paracrystalline and filamentous inclusions; 3) multivacuolated Leydig cells containing abundant lipid droplets; and 4) immature Leydig cells with scarce development of the smooth endoplasmic reticulum and mitochondria, and numerous cytoplasmic microfilaments. Abnormally differentiated Leydig cells might represent dysgenetic cells, whereas immature, normal, and vacuolated Leydig cells might represent three progressive stages in the Leydig cell cycle (undifferentiated, mature, and old involuting Leydig cells). An inverse correlation between the proportion of abnormal Leydig cells and testosterone levels was observed in each of these testicular disorders.

The formation of annulate lamellae in the human Sertoli cell

The formation of annulate lamellae (AL) has been studied in human Sertoli cells. Sertoli cells of infants did not show AL. Sertoli cells of 9- to 11-year-old boys showed incompletely circumferentially arranged cisternae of endoplasmic reticulum (ER), alternating with rows of vesicles, 200-300 nm in diameter, with a weakly osmiophilic content. The ER cisternae displayed both pores and attached ribosomes at a few sites. These membranous structures were also observed beside true concentrically arranged AL in pubertal Sertoli cells (11-13 years of age). Both types of membranous formations were continuous with parallel, rough endoplasmic reticulum cisternae (RER) that interconnected them. Adult Sertoli cells showed only AL, not the other peculiar membranous formation. These features suggest that the RER plus associated vesicles originate the AL in human Sertoli cells.

Mast cells in the human testis and epididymis from birth to adulthood

Mast cells are a constant cell-type in the connective tissues of the human testis and epididymis from birth to adulthood. Ultrastructural study shows that these cells are similar to those found in other connective tissues. Histometric studies revealed that the number of mast cells in the interstitium, mediastinum and albuginea of the testis as well as in the epididymal connective tissue increases slightly during infancy, decreases during childhood, and then increases again at puberty. Increases at puberty are particularly evident in both the testicular interstitium and the epididymis. During adulthood, the number of mast cells progressively decreases in all testicular and epididymal connective tissues. Changes in mast cell number may be related to changes observed in the development of testicular connective tissue which occurs primarily during infancy and puberty.

Testicular and epididymal involvement in Fabry's disease

Autopsy specimens of the testes and epididymis of a 32-year-old male with Fabry's disease were studied by light and electron microscopy. The characteristic ceramide deposits (lamellar inclusions, myeloid-bodies, zebra-bodies) were found in the Leydig cells as well as in the epithelial lining of both the ductuli efferentes and the ductus of the epididymis. Similar myeloid-bodies were observed in the blood vessels, connective tissue cells and muscle cells of the testicular interstitium, tunica albuginea and epididymis. In contrast, myeloid-bodies were absent or scarce in both the seminiferous epithelium and the mediastinum testis. However, the seminiferous tubules were severely affected showing reduced diameter, thickening of the tunica propria, and a few degenerated spermatogonia and primary spermatocytes. The different degrees of involvement of the testicular structures might be related to their different functions, the absorptive and permeable structures being the most severely affected. The development of testicular alterations seems to have been slow, since the patient fathered three children.

Elastic fibres of the human ductus deferens

The distribution of elastic fibres in the human ductus deferens from birth to senility was studied by light and electron microscopy. Elastic fibres are lacking in the ductus deferens in infants and children. In the adult ductus deferens, they form two layers in the lamina propria: (1) an inner layer of circumferentially oriented elastic fibres, and (2) an outer meshwork of elastic fibres. Elastic fibres are also present in the narrow intercellular spaces between the smooth muscle cells of the muscular coat, mainly in the inner muscular layer. A layer of elastic fibres surrounds the muscular coat. The ductus deferens of ageing subjects shows fragmentation and disorganisation of the elastic fibre layers of the lamina propria. Elastic fibres in the muscular coat are more abundant than in younger adults, forming larger bundles. Electron microscopy demonstrated the presence of immature elastic fibres at puberty as collections of microfibrils, some of them containing loci of amorphous substance (elastin). In the adult ductus most elastic fibres have a mature appearance. The amount of amorphous substance has increased and the number of microfibrils has decreased. Electron-dense inclusions are present within the amorphous substance. With advancing age the amorphous substance forms large, structureless masses showing abundant electron-dense inclusions and areas of rarefaction. A thin layer of microfibrils is present only at the periphery of the elastic fibres. Whether or not androgenic hormones are in any way involved in the formation of elastic fibres in the ductus deferens and testis is something which requires further study.