Sertoli cell proliferations of the infantile testis: an intratubular form of XXXX ?

@entity1 @entity248 @entity5 @entity1816 @entity11225 @entity2838 @entity75 @entity876 @entity247 @entity19464 @entity11187
We report on six @entity1 with intratubular Sertoli cell proliferations (ISCPs), studied by routine histologic methods, electron microscopy, and immunohistochemistry of anti-m  llerian hormone ( @entity248 ), @entity11225 -subunit, @entity1816 dehydrogenase ( @entity11187 ), proliferative cellular nuclear antigen, and @entity876 , and carefully followed for extended periods with periodic clinical examinations, testicular ultrasonographies, and determinations of serum levels of @entity248 and inhibin B. @entity2838 was found in four of six @entity1 , and @entity247 occurred in five of six @entity1 . One @entity1 had isosexual pseudoprecocity. ISCPs were observed as multiple foci of seminiferous tubules with large and proliferated Sertoli cells replacing germ cells and limited by the basement membrane. Mitotic figures, atypia, and/or interstitial invasion were not observed. Bilateral ISCPs were the only pathologic finding in three @entity1 ( @entity1 nos. 1-3) and were associated with a microscopic @entity5 that resembled a large-cell calcifying @entity19464 (LCCSCT) in a fourth @entity1 ( @entity1 no. 4). In the two remaining @entity1 ( @entity1 nos. 5 and 6) ISCPs and LCCSCT were found in both testes. Ultrastructural examination showed large Sertoli cells, with round nuclei, sparse organelles, and some glycogen. @entity11225 -subunit immunolocalization was positive in the five @entity1 in whom it was determined ( @entity1 nos. 2-6), @entity248 was positive in those ISCPs associated with @entity5 ( @entity1 nos. 4-6) and negative in isolated ISCPs ( @entity1 nos. 2 and 3); @entity11187 and PCNA were variable, and @entity876 was negative in all ISCPs. @entity1 nos. 1-4 have been followed for 2-19 years. One of them is currently entering puberty, the other two have already completed puberty and have testes of normal size, and the remaining one is an adult with clinically normal testes and sperm production. None of these @entity1 had evidence of @entity5 development during follow-up as shown by serial ultrasonographies and serum levels of @entity248 and inhibin B. @entity1 nos. 5 and 6 who had bilateral ISCPs and LCCSCT were orchidectomized and evolved for 2-10 years after surgery without @entity5 recurrence. The prognostic significance of ISCPs, particularly when they are the only pathologic finding in a testicular biopsy, is a matter of controversy. Based on the long normal evolution, we recommend a conservative approach to therapy. The bilateral and multicentric character of ISCPs and their association with Sertoli @entity5 and @entity2838 suggest that they represent either @entity75 with tumorigenic potential or the intraepithelial stage in the evolution of some testicular Sertoli cell @entity5 .
