Leydig cell hyperplasia
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Leydig cell hyperplasia is an uncommon benign pathology of the testis.[1] It may be seen in the ovary.
| 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 |
General
- Benign.
- Uncommonly seen in isolation by pathology.
A longer list of causes:[2]
- Congenital (primary).
- Secondary causes:
- Germ cell loss/decrease:
- Cryptorchidism.
- Advanced age.
- Endocrine-related:
- Adrenal hyperplasia.
- Excess hCG - exogenous or tumour.
- Germ cell loss/decrease:
Other associations:[2]
- Klinefelter's syndrome.[3]
- Pernicious anemia.
- Alcoholism.
- Infection - syphilis, tuberculosis.
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)
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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
- ↑ 1.0 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.
- ↑ 2.0 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.
- ↑ 3.0 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.