Testicular atrophy

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Testicular atrophy
Diagnosis in short

Atrophic changes of the testis (bottom). H&E stain.

Synonyms atrophic testis, atrophy of the testis

LM thickening of seminiferous tubule basement membrane, decreased sperm/no sperm present, +/-intertubular fibrosis
LM DDx sertoli cell nodule, testicular scar, germ cell neoplasia in situ, seminoma - esp. intertubular
Site testis

Clinical history +/-undescended testis (cryptorchidism)
Prevalence not common
Prognosis benign
Treatment long standing cryptorchidism - removal

Testicular atrophy is relatively common change seen in undescended testes. It is also known as atrophic testis and atrophy of the testis.

Cryptorchidism redirects here.

General

  • Microscopic appearance identical to cryptorchidism (undescended testis).[1]

Gross

  • Decreased size.[2]

Microscopic

Features:[1]

  • Thickening of seminiferous tubule basement membrane.
  • Intertubular fibrosis.
  • Decreased sperm/no sperm present.

Notes:

  • End-stage testicle - only has Sertoli cell within the seminiferous tubules.
  • Sertoli cells may have a cytoplasm with eosinophilic granules (lysosomes). This is a nonspecific finding described in several contexts.[3]

DDx:

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TESTICLE, RIGHT, ORCHIECTOMY:
- ATROPHIC TESTICLE.
- NEGATIVE FOR GERM CELL NEOPLASIA IN SITU (INTRATUBULAR GERM CELL NEOPLASIA).
- NEGATIVE FOR MALIGNANCY.

Micro

The sections show seminiferous tubules surrounded by thick hyaline sleeves. In a large number of sections only Sertoli cells are found in the tubules.

In some sections poorly defined paucicellular tubular structures reminiscent of seminiferous tubules composed of hyaline material are present; these probably represent obsolete seminiferous tubules. Focally, fibrosis is seen without definite tumour outlines. There is no significant inflammation. The rete testis is identified.

Rare seminiferous tubules have spermatid within. The germ cells seen do not have appreciable nuclear atypia.

Small Leydig cell clusters are seen in some sections.

See also

References

  1. 1.0 1.1 Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 506-7. ISBN 978-1416054542.
  2. Zvizdic Z, Milisic E, Halimic A, Zvizdic D, Zubovic SV (2014). "Testicular volume and testicular atrophy index as predictors of functionality of unilaterally cryptorchid testis". Med Arch 68 (2): 79–82. PMID 24937926.
  3. Nistal, M.; Garcia-Rodeja, E.; Paniagua, R. (Feb 1991). "Granular transformation of Sertoli cells in testicular disorders.". Hum Pathol 22 (2): 131-7. PMID 1672120.
  4. Henley, JD.; Young, RH.; Wade, CL.; Ulbright, TM. (Sep 2004). "Seminomas with exclusive intertubular growth: a report of 12 clinically and grossly inconspicuous tumors.". Am J Surg Pathol 28 (9): 1163-8. PMID 15316315.