Tag Archives: testis

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.

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Seminoma’s Architectural Variants, Immunophenotype and Differential Diagnostic

Loghin Andrada1, Preda O1, Nicolae Alina2, Aneiros J2, Borda Angela1, Nogales FF2

1 Department of Histology, University of Medicine and Pharmacy, Tîrgu Mureș, Romania
2 Department of Pathology, San Cecilio University Hospital, Granada, Spain

Introduction: Although rare, representing only 1–2% of all tumours in man, testicular germ cell tumours (TGCT) are the overwhelming majority (98%) of testicular neoplasms among male patients between 15 to 40 years of age. Due to their increasing incidence and the characteristically young targeted population, they become a problem of public health in some developed countries. Classically, TGCTs are classified in three main groups: classical seminoma, non-seminomatous germ cell tumours (pure or mixed) and the spermatocytic seminoma. As SS is a very rare tumour, with a benign evolution, in practice the main differential diagnosis to be made is between seminoma and non-seminomatous tumours. Distinguishing these two categories is essential as the prognostic and the therapeutic approach is very different: if radiotherapy is the main treatment for seminoma, for non- seminomatous tumour a cisplatin based chemotherapy will be proposed.
Material and methods: This study proposes a morphologic and immunohistochemical evaluation of an important number of seminomas emphasising their unusual architectural features.
Results: The majority of the seminomas (46 cases), either pure or as a component of non-seminomatous germ cell tumours, had a solid architecture. We identified syncytiotrophoblasts cells in only one case in conventional stain and 11 cases were associated with a scattered intertubular spread. Eighteen cases showed unusual patterns: tubular-trabecular (9 cases), microcystic areas (5 cases) and 4 seminomas had focal nuclear pleomorphism. Areas of focal or extensive fibrosis and hemosiderin laden macrophages were identified in 4 cases. IGCNU, conventional seminomas and all the unusual architectural variants of seminoma had the same immunoprofile: positivity for PLAP and negativity for AFP and CD30.
Conclusions: Our study confirms the high architectural variability of seminomas, with unusual histological patterns like intertubular, tubular-trabecular, microcystic and pleomorphic. In the great majority of cases, the diagnosis of seminoma relies on the histological pattern in conventional stain. Only few cases may be prone to be diagnostically challenging, including tumours with unusual patterns. In these circumstances, the use of a panel of antibodies is mandatory for a correct diagnosis.

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The Management of Cryptorchidism at the Pediatric Surgery Clinic of Tîrgu Mureș

Gozar H, Prișcă R, Derzsi Z

Pediatric Surgery Clinic, County Emergency Clinical Hospital, Tîrgu Mureș, Romania

DOI: 10.2478/amma-2013-0020

Introduction: Cryptorchidism is the most common abnormality of the male sexual development and one of the most common diagnoses in children hospitalized in the Pediatric Surgery Clinic. The diagnosis is mainly clinical: the testis cannot be seen or palpated in the scrotum. For this malformation, the treatment is always surgical: the orchiopexy.
Material and method: This is a retrospective study performed in 2012 in our clinic. The purpose of the study is to report our experience during a year in the management of this abnormality.
Results: There is a standard technique with two incisions (inguinal and scrotal) which was used in 77.12% of cases and a newer technique (Bianchi), with a single incision (scrotal), used in 22.88% of cases.
Conclusion: The results after surgery for cryptorchidism in every case were good, with both techniques.

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