histology | Acta Medica Marisiensis

Histological patterns of testicular biopsy in patients with azoospermia: single-institution experience

Nina Čamdžić¹, Višnja Muzika², Samra Čustović², Mirsad Babić¹, Mirsad Dorić¹, Edina Lazović Salčin¹, Suada Kuskunović-Vlahovljak¹

1. Department of Pathology, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
2. Department of Histology and Embryology, Faculty of Medicine, University of Sarajevo, Bosnia and Herzegovina

DOI: 10.2478/amma-2023-0038

Objective of this study was to identify the histopathological patterns and their frequency in testicular biopsy specimens from azoospermic patients and to categorize it according to Modified Johnsen scoring system.
Methods: Testicular biopsies from male patients with clinical diagnosis of azoospermia were included in this study. All tissue samples were fixed in buffered 10% formalin, routinely processed and stained with Hematoxylin and Eosin. All cases were examined microscopically and categorized according to the histopathological patterns and Modified Johnsen scoring system.
Results: Total 219 cases of testicular biopsies from 125 azoospermic male patients were evaluated, with 94 cases of bilateral testicular biopsy. The most prevalent age group was of 30-39 years (66.2%). The most common histological pattern was of Sertoli cell only syndrome (58.4%) while the least represented pattern was germ cell maturation arrest, seen in 4.6% cases. The most common Modified Johnsen score was 2 (66.7%). There was discordance in histologic pattern in both testes in 12.76% of patients who had bilateral testicular biopsy.
Conclusion: Our study gives an insight on the most common histopathological patterns of azoospermic patients and emphasizes the need for a better national statistics and epidemiological studies of this entity. It also points out the significance of the bilateral testicular biopsy, as both, diagnostic and therapeutic procedure.

Asymptomatic Myxomatous Degeneration of the Mitral Valve, in a Young Male

Carmen Opris¹, Horatiu Suciu^1,2, Catalin Satala³, Cosmin Banceu², Cosmin Opris¹, Alexandra Stoica², Tudor Capilna², Simona Gurzu^3,4

1. Department of Adult and Children Cardiovascular Recovery, Emergency Institute for Cardio-Vascular Diseases and Transplantation, Targu Mures, Romania
2. Department of Surgery, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania
3. Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania
4. Research Center (CCAMF), George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Romania

DOI: 10.2478/amma-2020-0018

Background: In young patients, the most common cause of mitral valve regurgitation is prolapse or flail of the valve, which is morphologically reflected by myxomatous degeneration. In rare cases, such this presented in this paper, this lesion might be incidentally identified, in young people.
Case presentation: A 43-year-old male, with familial history of hypertension, presented in our Department of Cardiology for a routine check-up. Despite of lack of symptoms, an intense murmur was detected at mitral auscultation area. The echocardiography revealed a severe mitral regurgitation caused by flail of posterior mitral valve. The patient was transferred to the Cardiac Surgery Department for surgical intervention consisting in mitral valve repair. The histopathological examination revealed severe myxomatous degeneration of the spongiosa and fibrosa layers. The recovery after surgery was very good with no postoperative complications. The patient was discharged seven days after surgery, with no significant mitral regurgitation at the three-month follow-up.
Conclusions: In young, asymptomatic patients, the proper time for mitral valve repair should be decided by an interdisciplinary team. For a better understanding of myxomatous degeneration particularities, histopathological assessment should be done in any replaced valve. Certification of such lesions, under microscope, might be an indicator for familial cardiovascular screening, in first degree relatives.