Experience with Testicular Touch Preparation Cytology in the Evaluation of Male Infertility.
Isil Z Yildiz-Aktas, Anil V Parwani, Walid E Khalbuss, Sara E Monaco, Liron Pantanowitz. University of Pittsburgh Medical Center, PA
Background: Male infertility is traditionally evaluated by tissue core biopsies of the testes. Touch preparations of these biopsies and fine needle aspiration of the testis have also been used in the past. The efficacy of testicular touch preparation (TP) cytology has not been widely reported. The aim of this study was to report our experience with using testicular biopsy TPs in the evaluation of male infertility.
Design: A retrospective search of our pathology computer database was conducted (2004 to 2010) for cases of testes biopsies with concurrent TP submitted to our department. These cases were further evaluated for clinical information (patient age, indication for biopsy), specimen adequacy, and cytological-histological correlation. In all cases, 6 core biopsies were performed from upper, middle and lower regions of bilateral testes with corresponding TP (6 TP slides/case with Pap stain). Slides from selected cases were reviewed.
Results: A total of 35 cases were identified from men with a mean age of 34 years (range 23 to 50 years). Clinical indication for biopsy included atrophic testes, azoospermia, Klinefelter syndrome, scrotal varices, testicular failure, and rule out carcinoma in situ. Histopathological diagnoses included 4 (11%) cases with complete spermatogenesis, 4 (11%) with hypospermatogenesis, 10 (29%) maturation arrest, and 17 (49%) with absent spermatogenesis, of which 5 (29%) were due to Sertoli cell-only syndrome. No intratubular germ cell neoplasia was diagnosed, confirmed using immunohistochemical studies in 4 cases with germ cell atypia. TP slides were satisfactory for evaluation in 31 (89%) cases, and less than optimal in 4 due to low cellularity, blood or air drying artifact. Cytopathology showed concordance with biopsy in all (100%) cases.
Conclusions: TP of the testis is a helpful adjunct to biopsy because of its ability to evaluate all stages of spermatogenesis. These data demonstrate that TP cytopathology of the testes in our experience has excellent correlation with both normal testicular biopsies and those showing pathologic spermatogenesis. Albeit uncommon, cytopathologists may be required to identify and evaluate spermatogenic elements in cytology specimens being submitted from men with infertility.
Wednesday, March 2, 2011 1:00 PM
Poster Session VI # 94, Wednesday Afternoon