Carcinoma in situ of the testis in infertile men. A histological, immunocytochemical, and cytophotometric study of DNA content

Abstract

Of 723 infertile men (128 with a history of cryptorchidism) whose testes were biopsied at the outer lateral face of the testis, five presented carcinoma in situ (CIS) in one testis. These testes were removed, serially sectioned, and examined by light microscopy. In order to evaluate whether only one or two biopsies are sufficient to diagnose CIS, before sectioning the testes four biopsies were taken at the anterior face, posterior face, superior pole, and inferior pole of the testis, respectively. Two of the five men had undergone orchiopexy in infancy and the testis contained tubules with Sertoli cells and isolated spermatogonia. CIS was also present in some tubules that were principally located near the rete testis. Of the four simulated biopsies, only that performed at the posterior face of the testis revealed CIS. The other three infertile men showed tubules with complete, although reduced, spermatogenesis, and tubules lined by Sertoli cells only. CIS was found in both types of tubules. These tubules with CIS formed lobules that extended throughout the testicular parenchyma. Most simulated biopsies performed in these three testes showed CIS. The average nuclear DNA content of CIS cells was about 4c in all testes. This content was similar both in tubules with complete spermatogenesis and in tubules with Sertoli cells only.

Interphase Cytogenetics of Carcinoma in situ of the Testis

“…The number of centro meres of a particular chromosome detected by ISH does not always parallel overall ploidy. This may be explained Even when CIS-SE and CIS-NS are different it is possi ble, and even likely, that they have a common precursor with a DNA content that is probably closer to tetraploid [28][29][30] and a phenotype similar to that of human primor dial germ cells, of which CIS cells are the neoplastic coun terparts.…”

Precursor Lesions of Urologic Malignancies

“…[146][147][148][149] In postpubertal men who are subfertile or infertile, the prevalence of GCNIS has been found to range from approximately 1% to 4%, although this depends on selection criteria for biopsy and the population demographics. [150][151][152] Germ cell neoplasia in situ is also associated with microlithiasis (although this finding is nonspecific), 153 which may partially account for the scrotal ultrasound irregularities that are often seen in testes with GCNIS. [154][155][156] Biopsy has long been and remains the gold standard for detection of isolated GCNIS when clinically suspected or in high-risk patients 157,158 ; in contrast, radical orchiectomy is performed and is both diagnostic and therapeutic in men with invasive GCTs, who typically present with a painless, palpable testicular mass.…”

Heterogeneity of expression of immunohistochemical tumour markers in testicular carcinoma in situ: pathogenetic relevance

“…One of them suggests that seminoma is the intermediate stage between a precursor germ cell and various forms of tumours included in a general group of nonseminomas. This model was set up mainly on the basis of the striking phenotypic resemblance of seminoma to the precursor CIS cell, on the relative DNA values, which in most reports were higher in CIS and seminomas (nearly tetraploid) than in nonseminomas (low triploid) [12,25,27,29], and on the results of comparative cytogenetic studies [17] and pathomorphological observations [3,28,33,38,41]. The other model of tumour progression suggests that seminoma and nonseminoma arise independently from a precursor germ cell.…”