Unexpected effect of testosterone in hypergonadotropic hypogonadism and nodular Leydig cell hiperplasia. Report of one case / Efecto inesperado de la testosterona en un hipogonadismo hipergonadotrófico e hiperplasia de las células de Leydig. Informe de un caso

ABSTRACT We report a 27 -year-old male referred because of hypergonadotropic hypogonadism with low testosterone and azoospermia. At 23 years of age, he underwent an excision of a hypoechoic 0.7 cm nodule of the left testicle. The pathological diagnosis was a Leydig cell tumor. In the right testicle, there were three nodules at ultrasound, the biggest measuring 0.6 cm. Four years later, the nodules in the right testicle were still present and the larger nodule was excised. The biopsy showed tubules with only Sertoli cells in the perinodular zone. Diffuse and nodular hyperplasia of the Leydig cells was found in the interstitium. The pathological diagnosis was Sertoli syndrome with severe hyperplasia of the Leydig cells. With testosterone therapy, LH decreased, and the nodules disappeared. Thereafter, upon interrupting therapy, LH increased, and the nodules reappeared in two occasions. Resuming testosterone treatment, the nodules disappeared again, suggesting a Leydig cell hyperplasia dependent on chronic LH stimulation.

Presentamos un varón de 27 años referido por hipogonadismo hipergonadotrófico con testosterona baja y azoospermia. El paciente tenía el antecedente de un nódulo sólido hipoecogénico de 0,7 cm en el testículo izquierdo, extirpado los 23 años de edad en el año 2002 y diagnosticado patológicamente como tumor de células de Leydig. En ese año se encontraron tres nódulos en el testículo derecho por ultrasonografía, el mayor de 0,6 cm. Cuatro años después, en 2007, los micronódulos del testículo derecho seguían presentes. El mayor de ellos fue extirpado. En la biopsia, había túbulos con solo células de Sertoli en la zona perinodular. En el intersticio había hiperplasia difusa y nodular de las células de Leydig. El diagnóstico patológico fue un síndrome de Sertoli con severa hiperplasia de células de Leydig. La terapia con testosterona disminuyó la LH y los nódulos inesperadamente desaparecieron. En dos ocasiones, al interrumpir esta terapia, la LH aumentó y los nódulos reaparecieron. Este proceso revirtió nuevamente con el uso de testosterona, sugiriendo una hiperplasia de células de Leydig dependiente del estímulo crónico de LH.

Numeric and volumetric changes in Leydig cells during aging of rats

Abstract Purpose: To analyze the effects of aging in rats on the nuclear volume, cytoplasmic volume, and total volume of Leydig cells, as well as their number. Methods: Seventy-two Wistar rats were divided into six subgroups of 12 rats, which underwent right orchiectomy at 3, 6, 9, 12, 18, and 24 months of age. The weight and volume of the resected testicles were assessed. A stereological study of Leydig cells was conducted, which included measurements of cell number and nuclear, cytoplasmic, and total cell volumes. Results: The weight and volume of the resected testicles showed reductions with age. Only the subgroup composed of 24-month old rats showed a decrease in the nuclear volume of Leydig cells. Significant reductions in the cytoplasmic volume and total volume of Leydig cells were observed in 18- and 24-month old rats. The number of Leydig cells did not vary significantly with age. Conclusions: Aging in rats resulted in reduction of the nuclear, cytoplasmic, and total cell volumes of Leydig cells. There was no change in the total number of these cells during aging.

possible correlation between the testicular structure and short photoperiod exposure in young albino rats: light and electron microscopic study

Light is considered as the first ecological factor affecting primary productivity. Several studies have attempted to relate between seasonal changed environmental light factors and the reproductive system. The influence of environmental light on the anatomy and physiology of different organs has been investigated intensely in a different species. Therefore, this research was designed to examine the effects of a short duration of light exposure on the histological structures of rat testes. Eighteen young male albino rats were divided into control [I] and experimental [II] groups. They were kept for 8 weeks in separate cages. The rats in group I were exposed daily to a normal lighting cycle of 12 h light and 12 h darkness. Light was provided by a 20-W 4-ft fluorescent lamp. Group II was exposed daily to 4 h of light and 20 h of darkness. They were housed in a small room. Its windows were covered with a black cotton material. At the end of the experiment, all rats were anaesthetized with ether, and their testes were dissected out and processed for light and electron microscopic examination. In group II, spermatogenic cells of some seminiferous tubules appeared separated and exfoliated. The other tubules were destroyed, with acidophilic hyaline material. Loss of germ cells was confirmed by a significantly low sperm count. Some germ cells showed a vacuolated cytoplasm and disrupted intercellular bridges with the formation of giant cells. Sertoli cells showed active phagocytic capacity with the appearance of multivesicular bodies. Hormonal assay showed a low significant testosterone level; this was supported by the presence of inactive spindle-shaped Leydig cells. The present study confirmed that rats were structurally and functionally photosensitive. Therefore, the changes in the normal photoperiod could influence their reproductive functions

La lepra y el testículo / Leprosy and the testis

Introducción. La afección testicular es frecuente en la lepra lepromatosa, daño que se incrementa cuando cursa con eritema nudoso leproso. Objetivo. Presentar un paciente con lepra lepromatosa y eritema nudoso leproso con grave compromiso testicular. Materiales y métodos. Se estudió un hombre de 28 años con lepra lepromatosa desde los 22, que durante la poliquimioterapia para la lepra presentó eritema nudoso leproso crónico que afectó ambos testículos y no respondió al manejo convencional. El dolor persistente obligó a practicar orquidectomía izquierda. Resultados. Este testículo presentaba atrofia tubular y fibrosis notorias, conglomerados de macrófagos espumosos, sin bacilos, hiperplasia focal de células de Leydig, endarteritis y arteritis linfocitaria y granulomatosa de vasos pequeños y medianos; estos cambios también estaban presentes en el epidídimo. Un estudio llevado a cabo dos años después de terminar su tratamiento y de la orquidectomía izquierda, demostró azoospermia, testosterona total normal, testosterona libre discretamente disminuida y hormonas lutropina (luteinizante) y folitropina (estimulante del folículo) elevadas. No había disminución de la libido ni de su actividad sexual. Se revisaron los conceptos generales sobre el eritema nudoso leproso y las alteraciones que la lepra produce en el testículo. Conclusión. La lepra lepromatosa puede conducir a hipogonadismo. Los programas de lepra deben contemplar esta complicación para corregir y evitar sus secuelas.

Introduction. Damage of testicles is frequent in lepromatous leprosy and worsened by the presence of erythema nodosum leprosum. Objective. A patient is presented who developed lepromatous leprosy and erythema nodosum leprosum with major testicular compromise. Material and methods. The 28-year-old male patient had lepromatous leprosy since age 22. During a polychemotherapy treatment for the lepromatous leprosy, he presented chronic erythema nodosum leprosum that affected both testicles; he did not respond to the conventional treatment. A left orchidectomy was performed to treat the persistent pain. Results. The extracted testis evidenced the following: tubular atrophy, extensive fibrosis, cumulus of foamy macrophages without rods, focal Leydig cell hyperplasia, linfocitary and granulomatous arteritis and endarteritis of small and medium size vessels. These changes were also observed in the epididymis. Two years after the polychemoterapy and the orchidectomy, the patient exhibited azoospermy, normal total testosterone, slightly diminished free testosterone and elevated levels of luteinizing hormone and follicle-stimulating hormone. No loss of libido or sexual activity was reported. General concepts of erythema nodosum leprosum were reviewed, as well as the pathologic changes produced by leprosy in the testis. Conclusion. Lepromatous leprosy may lead to hypogonadism. This condition is recommended for inclusion in leprosy diagnostic programs in order to detect and treat the consequences of the possible hypogonadism.

Effect of colchicine on the histology of spleen and testis of albino rats

The aim of this work is to study the effect of colchicine administration on the histology of spleen and testis of albino rat. Colchicine was given in a daily dose of 3mg/kg body weight for five days. Animals were sacrificed at 1, 4 and 7 days following treatment. Histopathological studies of the spleen and testis were undertaken. Histological examination of spleen showed that colchicine caused histopathological changes in spleen manifested by massive haemorrhage, highly expanded red pulps accompanied by reduced white pulps with multi small degenerated areas, disturbed architecture, degenerated areas were occupied by the hemorrhagic areas, prominent haemosiderin deposition, increased number of megakaryocytes in red pulp and subcapsular edema. These histopathological changes depend on the duration of colchicine intake. Histological examination of the testis one, four and seven days post treatment with colchicine showed dilatation and congestion of interstitial blood vessels, moderate degeneration of spermatogoneal cells, debris of spermatozoa could be detected in the lumen of the seminiferous tubules. The testis also suffered from interstitial edema with signs of fatty degeneration and degeneration of spermatogoneal cells lining some seminferous tubules. Complete destruction with hypocellularity in the spermatogenic layers in some seminiferous tubules and others contained only the debris of germ cells and disturbed nuclei of spermatogoneal cells with appearance of giant cells with highly reduced number of Leydig cells which contained pyknotic nuclei were also noticed in some examined sections. These results indicate that colchicine is considered as a toxic drug to the spleen and testis at double therapeutic doses as indicated by the histological changes

Hipoplasia das células de Leydig / Leydig cell hypoplasia

A hipoplasia das células de Leydig é uma forma rara e bem definida de pseudo-hermafroditismo masculino de herança autossômica recessiva. A inadequada diferenciação das células de Leydig fetais e, conseqüentemente, a baixa produção androgênica na vida intra-uterina e no período pós-natal resultam em ausência ou incompleta virilização em indivíduos com cariótipo 46,XY. Os portadores desta anomalia apresentam um amplo espectro clínico, desde um fenótipo feminino normal até genitália externa masculina com micropênis, com baixas concentrações de testosterona e elevadas de LH. Mutações inativadoras no gene do receptor de LH/hCG têm sido identificadas em diversas famílias afetadas na última década. Entretanto, a baixa freqüência de mutações inativadoras neste gene e a falta de segregação de polimorfismos intragênicos entre os membros afetados de famílias com fenótipo típico de hipoplasia das células de Leydig, sugerem a heterogeneidade genética desta condição.

Tumor masculinizante de ovario: a propósito de un caso / Masculinizing tumor of ovary (with regard to a case)

Se reporta el caso de una paciente de 63 años, con 6 años de evolución de alopecia, hirsutismo, voz ronca y clitorimegalia. Se le encontraron niveles altos de testosterona (263 ng/dl), el ultrasonido transvaginal demostró una lesión sólida en el ovario izquierdo. El manejo consistió en histerectomía abdominal y salpingooforectomía bilateral. La biopsia indicó un tumor benigno esteroidogénico tipo células de Leydig. La paciente evolucionó satisfactoriamente, con mejoría parcial de sus manifestaciones en el control postoperatorio de 4 meses. Descriptores: Hirsutismo, alopecia, clitorimegalia, tumor de células de Leydig.

Carcinoma testicular in situ: seguimiento a 13 años / Testicular carcinoma in situ: pursuit to 13 years

El carcinoma in situ testicular (CisT) es una lesión considerada precursora de los tumores testiculares de células germinales (TCG). Estudios en pacientes con TCG han mostrado que un 50 porciento de los que tienen un CisT en biopsias del testículo contralateral desarrollan una enfermedad invasora a 5 años, si no sontratados. El objetivo de esta comunicación fue describir la evolución a largo plazo de un grupo de pacientes con diagnóstico de CisT contralateral, en nuestra serie de pacientes con TCG. Este estudio retrospectivo incluye 194 pacientes con orquidectomías radicales por TCG entre enero 1985 y diciembre 1992. Se registraron: datos demográficos de los pacientes, tratamiento, realización de biopsia testicular contralateral, anatomía patológica y seguimiento. La información clínica fue obtenida de una base de datos computarizada y el seguimiento de los pacientes con CisT se realizó a través de registros clínicos, entrevista telefónica y visita médica. La edad promedio de los pacientes fue de 32,2 (4-82) años. Se realizó biopsia testicular contralateral en 30 pacientes (15 porciento). En las biopsias testiculares se observan 5 pacientes (16 porciento) con CisT, 8 (27 porciento) conatrofia y 17 (57 porciento) con tejido normal. Ninguno de los 5 pacientes con CisT tenía antecedentes decriptorquídea. El tiempo de seguimiento medio fue de 159 (138-210) meses para los pacientes con CisT. De éstos, 3 pacientes se controlaron en forma periódica sin recibir tratamiento complementario, un pacientere cibió radioterapia testicular y el otro se realizó una orquidectomía contralateral. De los 4 pacientescon testículo in situ ninguno ha presentado clínica sugerente de tumor testicular. Tampoco han presentado recidiva de enfermedad hasta septiembre de 2003. La prevalencia de CisT (16 porciento) en este grupo de pacientes es superior a la reportada por series extranjeras. No se observó evolución hacia una forma invasora en ninguno de los pacientes con diagnóstico luego de 13 años de seguimiento.

Pseudohermafroditismo masculino por hipoplasia de las células de leyding / Male pseudohermaphroditism by hypoplasia of the leyding

En el presente trabajo se resumen los hallazgos clínicos, de laboratorio endocrinológico e histopatológico de un niño con cariotipo masculino (46 XY) y genitales externos e identificación social femeninos, catalogado como un caso raro de Pseudohermafroditismo masculino por hipoplasia de las células de leydig

Función de las células de Leydig en estados de hiper o hipoprolactinemia en hombres sanos / Leyding cells function in hyper or hipoprolactinaemic states in healthy men

En el presente trabajo se estudió la función de las células de Leydig, mediante la estimulación con 2000 UI de GCh, en 11 hombres sanos, antes y después de la inducción de hiper o hipoprolactinemia, con sulpiride o bromocriptina respectivamente. La respuesta normal a la estimulación con GCh se caraterizó por un incremento del estradiol sérico a las 24 horas y de la testosterona a las 72 horas, después de la administración de la gonadotropina. Los niveles séricos de FSH disminuyeron durante la prueba. La hiperprolactinemia se acompaño con un aumento de la LH sérica y de un menor incremento del estradiol sérico observado 24 horas después de la administración de la GCh. Por otro lado la hipoprolactinemia disminuyó los niveles séricos basales de testosterona, pero incrementó la respuesta de este esteroide a la GCh. Estos resultados sugieren que la hiperprolactinemia interfiere con la síntesis del estradiol; mientras que la pérdida del efecto trófico de la PRL sobre la esteroidogénesis, en los estados de hipoprolactinemia, disminuye la testosterona sérica basal, pero no altera la respuesta esteroidogénica al estímulo con la GCh. Por ello se concluye que la PRL juega un papel importante en la esteroidogénesis de la células de Leydig en el hombre sano

Ovarian serous cystadenoma associated with Sertoli-Leydig cell tumor: a case report

We Describe a case of ovarian serous cystadenoma having Sertoli-Leydig cell tumor, well differentiated, in the cystic septum. Well differentiated Sertoli-Leydig cell tumor coexisting with other tumor, including serous tumor, has not yet been described. In all cases of Sertoli-Leydig cell tumor with heterologous components or other tumors, the androblastomatous components are intermediately or poorly differentiated. The present case revealed a well differentiated Sertoli-Leydig cell tumor arising in a septum of serous cystadenoma, as a circumscribed nodule. With these findings, we discuss the possibility of this Sertoli-Leydig cell tumor, considered a mural nodule, which is well established in cystic common epithelial tumors of the ovary.

Quantificaçäo numérica das células de Leydig nos testículos humanos adultos / Quantitative estimate of Leydig cells in adult human testes

Dez testículos de indivíduos normais, na faixa etária de 20 a 40 anos e que tiveram morte violenta, foram coletados no necrotério da Faculdade de Medicina da Universidade de Säo Paulo. O número médio de células Leydig em um testículo de indivíduo sem antecedentes de patologia genital foi aproximadamente de 140 milhöes

Effect of hypobaric hypoxia on spermatogenesis, Leydig cells and delta 5-3 beta-hydroxysteroid dehydrogenase activity in toad.

The effect of different grades of hypobaric hypoxia for 48 hours was studied on spermatogenesis, Leydig cells and delta 5-3 beta-hydroxysteroid dehydrogenase activity in toad (Bufo melanostictus). Maximum inhibition of testicular activity was noted in 7,315 m exposed animals. The impairment of testicular function at high altitude is possibly due to inhibition of gonadotrophin secretion.