Ultrastructural Lesions in Testes from Hyperprolactinemic Men

Abstract

Testicular tissue from eight men with prolactinomas and elevated serum prolactin were evaluated by light (LM) and transmission electron microscopy (TEM). A semiquantitative assessment of testicular morphology was employed to provide a morphology index for each tissue specimen. Although in each biopsy specimen germ cell exfoliation was evident, as was abnormal structural change in the seminiferous epithelium, there was no apparent correlation with the overall degree of tissue pathology (morphology index) and the serum level of prolactin. All of the tissue displayed variably thickened seminiferous tubule walls which, when viewed by TEM, were composed of thickened laminae propriae and redundant and involuted basal laminae. Likewise, all tubules contained Sertoli cells with overt cytoplasmic degeneration, principally in the apical (adluminal) region of the cell. This was visualized, in part, as a retraction of the apical cytoplasm from periluminal spermatids and degeneration or absence of Sertoli-germ cell junctional specializations. Sertoli-Sertoli cell junctional complexes appeared structurally intact. Leydig cell ultrastructure was typical of normal cells and contained a variable amount of lipid and smooth endoplasmic reticulum. This also was without positive correlation with the overall degree of tissue pathology or level of serum prolactin. Our results demonstrate the variable degree of testicular pathology associated with hyperprolactinemia in man, and suggest that abnormal tubule walls and altered Sertoli cell ultrastructure are consistent findings in this abnormal endocrine condition.

Interstitial compartment pathology and spermatogenic disruption in testes from impotent diabetic men

“…'Score represents a n average score of all tubules observed. aldehyde in 0.1 M cacodylate buffer (pH 7.4) and routinely processed for light and electron microscopy as previously described (Cameron et al, 1984). During the biopsy procedure and all subsequent procedures, extreme care was taken to prevent unnecessary tissue handling to minimize the possibility of mechanically induced artifacts.…”

“…Control and diabetic biopsy tissue was thick sectioned and evaluated histologically (Morphology Index) as de- scribed below and thin sectioned for transmission electron microscopy as previously described (Cameron et al, 1984). Some tissue was processed for scanning electron microscopy prior to tissue embedding also as previously described (Cameron and Snydle, 1982).…”

“…Individual tubules and sections were scored for each category from which an average was computed to give a final score ( Table 2). Details of the Morphology Index have been reported previously (Cameron et al, 1984). Parameters scored included A) the thickness of the tubule wall (i.e., all wall elements from the germinal epithelium to the outermost layer of peritubular fibroblasts), B) the diameter of the tubule, C) the tubule lumen, D) organization of the seminiferous epithelium, E) the presence of spermatids in various stages of differentiation within the epithelium or the tubule lumen, and F) the apparent number of Leydig cells (hyper-or hypoplasia).…”

The treatment with cabergoline for 24 month normalizes the quality of seminal fluid in hyperprolactinaemic males

“…In seasonally breeding mammals it acts as a signal to start or interrupt reproductive activity 1,2 by modifying pituitary gonadotrophin secretion and/or by modulating LH receptor number in Leydig cells in some species 3,4 . In man, hyperprolactinaemia induces impairment of spermatogenesis, 5–7 likely by suppressing LH and, consequently, testosterone secretion 5,8 . Impairment of gonadal and sexual function is indeed the first and most relevant complaint of men with hyperprolactinaemia 9 .…”

“…3,4 In man, hyperprolactinaemia induces impairment of spermatogenesis, [5][6][7] likely by suppressing LH and, consequently, testosterone secretion. 5,8 Impairment of gonadal and sexual function is indeed the first and most relevant complaint of men with hyperprolactinaemia. 9 Dopamine agonists, especially with D 2 selective receptor agonist cabergoline, are well documented to control hyperprolactinaemia and tumour mass in women.…”