Difference between revisions of "Leydig cell hyperplasia"

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'''Leydig cell hyperplasia''' is an uncommon [[pathology]] of the [[testis]].  It may be seen in the [[ovary]].
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Leydig cell hyperplasia -- low mag.jpg
| Width      =
| Caption    = Leydig cell hyperplasia. [[H&E stain]]. (WC)
| Synonyms  =
| Micro      = abundant Leydig cells interspersed between seminiferous tubules with only Sertoli cells, Leydig cells do not displace or compress the seminiferous tubules
| Subtypes  =
| LMDDx      = [[Leydig cell tumour]], [[testicular adrenal rest tumour]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Staging    =
| Site      = [[testis]], [[ovary]]
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = rare
| Bloodwork  =
| Rads      = hypoechoic lesions on ultrasound, often multiple
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    =
| Tx        =
}}
'''Leydig cell hyperplasia''' is an uncommon benign [[pathology]] of the [[testis]].<ref name=pmid12540460>{{Cite journal  | last1 = Carucci | first1 = LR. | last2 = Tirkes | first2 = AT. | last3 = Pretorius | first3 = ES. | last4 = Genega | first4 = EM. | last5 = Weinstein | first5 = SP. | title = Testicular Leydig's cell hyperplasia: MR imaging and sonographic findings. | journal = AJR Am J Roentgenol | volume = 180 | issue = 2 | pages = 501-3 | month = Feb | year = 2003 | doi = 10.2214/ajr.180.2.1800501 | PMID = 12540460 }}</ref> It may be seen in the [[ovary]].


==General==
==General==
*May be seen in the context of ''[[Klinefelter syndrome]]''.<ref name=pmid26209412>{{Cite journal  | last1 = Sterbis | first1 = J. | last2 = E-Nunu | first2 = T. | title = Leydig cell hyperplasia in the setting of Klinefelter syndrome. | journal = BMJ Case Rep | volume = 2015 | issue =  | pages =  | month =  | year = 2015 | doi = 10.1136/bcr-2015-209805 | PMID = 26209412 }}</ref>
*Benign.
*Uncommonly seen in isolation by pathology.
 
A longer list of causes:<ref name=pmid9488073>{{Cite journal  | last1 = Naughton | first1 = CK. | last2 = Nadler | first2 = RB. | last3 = Basler | first3 = JW. | last4 = Humphrey | first4 = PA. | title = Leydig cell hyperplasia. | journal = Br J Urol | volume = 81 | issue = 2 | pages = 282-9 | month = Feb | year = 1998 | doi = 10.1046/j.1464-410X.1998.00503.x | PMID = 9488073 }}</ref>
*Congenital (primary).
*Secondary causes:
**Germ cell loss/decrease:
***[[Cryptorchidism]].
***Advanced age.
**Endocrine-related:
***Adrenal hyperplasia.
***Excess hCG - exogenous or tumour.
 
Other associations:<ref name=pmid9488073/>
*[[Klinefelter's syndrome]].<ref name=pmid26209412>{{Cite journal  | last1 = Sterbis | first1 = J. | last2 = E-Nunu | first2 = T. | title = Leydig cell hyperplasia in the setting of Klinefelter syndrome. | journal = BMJ Case Rep | volume = 2015 | issue =  | pages =  | month =  | year = 2015 | doi = 10.1136/bcr-2015-209805 | PMID = 26209412 }}</ref>
*[[Pernicious anemia]].
*[[Alcoholism]].
*Infection - [[syphilis]], [[tuberculosis]].


==Gross==
==Gross==
*Unremarkable.
Features:
*Unremarkable gross appearance of parenchyma. (???)
*Normal or small testis. (???)


Note:
Note:
*Hypoechoic lesions on ultrasound.<ref name=pmid26209412/>
*Hypoechoic lesions on ultrasound - often multiple, small.<ref name=pmid26209412/>


==Microscopic==
==Microscopic==
Features:
Features:
*Abundant Leydig cells interspersed between tubules with only Sertoli cells.
*Abundant Leydig cells interspersed between seminiferous tubules with only Sertoli cells.
**Leydig cells do ''not'' displace or compress the seminiferous tubules.
 
Note:
*May form nodules up to 6 mm.<ref name=pmid12540460/>


DDx:
DDx:
*[[Leydig cell tumour]].
*[[Leydig cell tumour]].
*[[Testicular adrenal rest tumour]].
===Images===
<gallery>
Image: Leydig cell hyperplasia -- very low mag.jpg | LCH - very low mag. (WC)
Image: Leydig cell hyperplasia - alt -- very low mag.jpg | LCH - very low mag. (WC)
Image: Leydig cell hyperplasia -- low mag.jpg | LCH - low mag. (WC)
Image: Leydig cell hyperplasia -- intermed mag.jpg | LCH - intermed. mag. (WC)
Image: Leydig cell hyperplasia -- high mag.jpg | LCH - high mag. (WC)
Image: Leydig cell hyperplasia - alt -- high mag.jpg | LCH - high mag. (WC)
</gallery>
==Sign out==
<pre>
Testicle and Cord, Right, Orchitectomy:
- Leydig cell hyperplasia.
- Atrophic testis.
- NEGATIVE for germ cell neoplasia in situ (intratubular germ cell neoplasia).
- NEGATIVE for malignancy.
Comment:
Immunostains confirm the morphologic impression.
The Leydig cells are POSITIVE for inhibin, calretinin and melan A. The section is
NEGATIVE for PLAP and has a benign pattern for D2-40.
</pre>


==See also==
==See also==

Latest revision as of 11:40, 25 June 2016

Leydig cell hyperplasia
Diagnosis in short

Leydig cell hyperplasia. H&E stain. (WC)
LM abundant Leydig cells interspersed between seminiferous tubules with only Sertoli cells, Leydig cells do not displace or compress the seminiferous tubules
LM DDx Leydig cell tumour, testicular adrenal rest tumour
Site testis, ovary
Prevalence rare
Radiology hypoechoic lesions on ultrasound, often multiple
Prognosis benign

Leydig cell hyperplasia is an uncommon benign pathology of the testis.[1] It may be seen in the ovary.

General

  • Benign.
  • Uncommonly seen in isolation by pathology.

A longer list of causes:[2]

  • Congenital (primary).
  • Secondary causes:
    • Germ cell loss/decrease:
    • Endocrine-related:
      • Adrenal hyperplasia.
      • Excess hCG - exogenous or tumour.

Other associations:[2]

Gross

Features:

  • Unremarkable gross appearance of parenchyma. (???)
  • Normal or small testis. (???)

Note:

  • Hypoechoic lesions on ultrasound - often multiple, small.[3]

Microscopic

Features:

  • Abundant Leydig cells interspersed between seminiferous tubules with only Sertoli cells.
    • Leydig cells do not displace or compress the seminiferous tubules.

Note:

  • May form nodules up to 6 mm.[1]

DDx:

Images

  • LCH - very low mag. (WC)

  • LCH - very low mag. (WC)

  • LCH - low mag. (WC)

  • LCH - intermed. mag. (WC)

  • LCH - high mag. (WC)

  • LCH - high mag. (WC)

Sign out

Testicle and Cord, Right, Orchitectomy:
- Leydig cell hyperplasia.
- Atrophic testis.
- NEGATIVE for germ cell neoplasia in situ (intratubular germ cell neoplasia).
- NEGATIVE for malignancy.

Comment:
Immunostains confirm the morphologic impression.

The Leydig cells are POSITIVE for inhibin, calretinin and melan A. The section is
NEGATIVE for PLAP and has a benign pattern for D2-40.

See also

References

  1. ↑ 1.0 1.1 Carucci, LR.; Tirkes, AT.; Pretorius, ES.; Genega, EM.; Weinstein, SP. (Feb 2003). "Testicular Leydig's cell hyperplasia: MR imaging and sonographic findings.". AJR Am J Roentgenol 180 (2): 501-3. doi:10.2214/ajr.180.2.1800501. PMID 12540460.
  2. ↑ 2.0 2.1 Naughton, CK.; Nadler, RB.; Basler, JW.; Humphrey, PA. (Feb 1998). "Leydig cell hyperplasia.". Br J Urol 81 (2): 282-9. doi:10.1046/j.1464-410X.1998.00503.x. PMID 9488073.
  3. ↑ 3.0 3.1 Sterbis, J.; E-Nunu, T. (2015). "Leydig cell hyperplasia in the setting of Klinefelter syndrome.". BMJ Case Rep 2015. doi:10.1136/bcr-2015-209805. PMID 26209412.
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