Male infertility

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Male infertility
Diagnosis in short

Mixed pattern male infertility (Sertoli cells only mixed with hypospermatogensis). H&E stain.

LM various patterns - see microscopic
LM DDx germ cell neoplasia in situ, germ cell tumour, inflammation of the testis
Site testis, vas deferens and other sites

Prevalence not very common
Prognosis benign
Clin. DDx (clinical diagnosis)
Treatment dependent on underlying cause

Male infertility is a clinical diagnosis. It is pretty much the only reason for a testicular biopsy.

This article focuses on the testicular causes of infertility. Testicular biopsy redirects to here.

General

It can be divided into:[1]

Microscopic

Male infertility on testicular biopsy shows one the following patterns:[1]

  1. Normal testis.
  2. Hypospermatogensis.
  3. Maturation arrest.
  4. Sertoli cells only.
  5. Seminiferous tubule hyalinization
  6. Some combination of the above patterns.

DDx:

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  • The diagnosis should be the pattern (#1-6 above).

The following should be commented on:

  • The number of tubules.
  • The number of tubules with sperm.
  • Hyalinization of the tubules.
  • Inflammation.
  • Absence of germ cell neoplasia in situ.

Mixed pattern

LEFT TESTIS, BIOPSY FOR SPERM RETRIEVAL:
- SERTOLI CELLS ONLY REGIONS (25% OF BIOPSY) INTERMEIXED WITH
  HISTOLOGICALLY NORMAL TESTIS (75% OF BIOPSY) WITH NORMAL NUMBERS
  OF SPERM.
- NEGATIVE FOR SIGNIFICANT SEMINIFEROUS TUBULE HYALINIZATION.
- NEGATIVE FOR SIGNIFICANT INFLAMMATION.
- NEGATIVE FOR GERM CELL NEOPLASIA IN SITU (INTRATUBULAR GERM CELL NEOPLASIA).

See also

References

  1. 1.0 1.1 Cerilli, LA.; Kuang, W.; Rogers, D. (Aug 2010). "A practical approach to testicular biopsy interpretation for male infertility.". Arch Pathol Lab Med 134 (8): 1197-204. doi:10.1043/2009-0379-RA.1. PMID 20670143.
  2. Niedziela, M.; Joanna, T.; Piotr, J. (Sep 2012). "Testicular adrenal rest tumors (TARTs) as a male infertility factor. Case report.". Ginekol Pol 83 (9): 700-2. PMID 23342900.