Beitrag zu den sogenannten hypoplastischen Zonen und den Ringtubuli der menschlichen Hoden
| Autor: | L. Török, G. Börsch, J. Mauss |
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| Rok vydání: | 2009 |
| Předmět: | |
| Zdroj: | Andrologia. 6:203-209 |
| ISSN: | 1439-0272 0303-4569 |
| Popis: | Zusammenfassung Verff. berichten in Verbindung mit 2 eigenen Fallen uber die sogenannten hypoplastischen Zonen und die Ringtubuli der Hoden und geben eine kurze Ubersicht uber die in der Literatur mitgeteilten Beobachtungen. Summary The authors report two cases with the so called hypoplastic zones and the so called ring-like tubules in testicular biopsies. Hypoplastic zones were found in a patient with bilateral cryptorchidism, ring-like tubules in a patient with hypogonadotropic hypogonadism. Both histologic changes are documented by photographic plates, their etiology and significance is discussed in connection with a short review of the literature. Hypoplastic zones may be defined as isolated lesions of the testis, consisting of tubules with prepuberal features. They were originally attributed to a delayed maturation of the seminiferous epithelium as a consequence of the abnormal position of the undescended testis. More recently, they were considered to indicate congenital, intrinsic defectiveness. This theory, however, has not remained unchallenged, since hypoplastic zones can be found with some frequency in descended and apparently normal testes as well. The appreciation of intratubular bodies in ring-like tubules has been even more inconsistent. Other names for intratubular bodies include stones, concrements and calco-spherules. Their origin has been traced to displaced spermatogonia, to a secretory product of Sertoli cells, or to oocytes. Even their intratubular location has been disputed. Two morphologic types of bodies may be distinguished: homogeneous and laminated bodies. The latter are usually associated with typical changes of the corresponding tubules, featuring two distinct layers of cells which lie against the basement membrane and closely around the central body, respectively. While several authors have taken intratubular bodies as evidence of testicular dysgenesis, others feel that they may have no serious implications. Our demonstration of intratubular bodies in a patient with hypogonadotropic hypogonadism and thus secondary testicular failure seems to support the latter opinion. Resumen Los autores aportan dos biopsias testiculares pertenecientes a un paciente criptor-quidico y a un hipogonadismo hipogonadotrofico en las que encuentran «zonas hipoplasicas» y «tubulos como anillos». «Zonas hipoplasicas» se pueden definir como lesiones aisladas del testiculo, consistentes en tubulos con imagen prepuberal. Originariamente, se atribuyeron a alteracion de la maduracion del epitelio germinal secundaria a la posicion anormal del testiculo no descendido. Recientemente, se considera como defecto intrinseco, congenita. Estas «zonas hipoplasicas», no obstante, se han encontrado tambien en testiculos descendidos y aparentemente normales. La apreciacion de cuerpos intratubulares, ha sido mas inconstante. Su origen se ha atribuido a espermatogonias alteradas, a producto de la celula de Sertoli o a oocitos. Su lo calizacion intratubular ha sido discutida. Se pueden distinguir dos tipos morfologicos de cuerpos: cuerpos homogeneos y laminados, los ultimos son generalmente asociados con cambios tipicos de los tubulos correspondientes que forman dos capas distintas de celulas que se apoyan contra la membrana basal y rodean estrechamente el cuerpo central respectivamente. Miemtras que unos autores han considerado los cuerpos intratubulares como evidencia de disgenesia testicular, otros creen que no significan complicaciones serias. Nuestra demostracion, comentan los autores, de cuerpos intratubulares en un paciente con hipogonadismo hipogonadotrofico y por tanto fallo testicular secundario, parece apoyar la ultima opinion. |
| Databáze: | OpenAIRE |
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