Identify this testicular pathology causing male infertility :(Left image is normal ,shown for comparison).
C. Mumps orchitis
D. Maturation arrest
Image shows: Microscopic appearance of normal testis (A) contrasted with that of cryptorchid testis (B).
- Cryptorchidism or undescended testis is a condition in which the testicle is arrested at some point along its descent.
- Its incidence is about 0.2% in adult male population.
- In 70% of cases, the undescended testis lies in the inguinal ring, in 25% in the abdomen and, in the remaining 5%, it may be present at other sites along its descent from intra-abdominal location to the scrotal sac.
- Cryptorchidism is unilateral in 80% cases and bilateral in the rest.
- Grossly, the cryptorchid testis is small in size, firm and fibrotic.
- Histologically, contrary to previous beliefs, the changes of atrophy begin to appear by about 2 years of age. These changes are as under :
1. Seminiferous tubules: There is progressive loss of germ cell elements so that the tubules may be lined by only spermatogonia and spermatids but foci of spermatogenesis are discernible in 10% of cases.
- The tubular basement membrane is thickened.
- Advanced cases show hyalinised tubules with a few Sertoli cells only, surrounded by prominent basement membrane.
2. Interstitial stroma: There is usually increase in the interstitial fibrovascular stroma and conspicuous presence of Leydig cells, seen singly or in small clusters.