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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== | ||
* | *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== | ||