Biomedical subjects

M Nistal

Publications and source records attributed to M Nistal.

At least 73 records · Page 4Linked to original sources

PubMed1992

The peritubular myoid cells in the testes from men with varicocele: an ultrastructural, immunohistochemical and quantitative study.

Ultrastructural and some immunophenotypic features of the peritubular myoid cells of testes from normal men and from men with varicocele were studied. The seminiferous tubules were classified into five types (a-e), related to the progressive degree of sclerosis measured as thickening of the lamina propria. In normal testes only type a and b tubules were found, whereas the testes from men with varicocele showed type b-e tubules. Myoid cells in tubule types a and b showed slender cytoplasmic projections with abundant, parallel arranged microfilament bundles and electron-dense bodies. In c tubules, the myoid cells showed the same ultrastructure. The myoid cells of tubules with advanced (type d) or complete (type e) sclerosis showed irregularly outlined nuclei, scant microfilament bundles and absence of electron-dense bodies. Immunostaining of myoid cells with anti-actin antibodies was intense in types a-c tubules and scant in types d and e. Immunostaining with anti-desmin antibodies was intense in tubules types a-d, but the immunoreactive cells in types c and d tubules were irregularly shaped and distributed and were scanty in tubule type e. Immunostaining with anti-vimentin antibodies was weak in types a-c tubules and intense in types d and e tubules. Quantitative studies revealed that, with the progression of sclerosis, the numbers of both actin- and desmin-immunoreactive cells per cross-sectioned tubule, and the surface area occupied by the immunostained portion of these cells, decreases while the number of vimentin-immunoreactive cells and their immunostained surface area increases.

Adult↗

PubMed1992

The ampulla of the ductus deferens in man: morphological and ultrastructural aspects.

In order to compare the histology of the ampulla of the ductus deferens with that of the other segments of the duct in man, the seminal vesicle and the adjacent 13-15 cm of the ductus deferens were obtained during cystectomy from 15 adult men, and were processed for light and electron microscopy. Each ductus deferens specimen was divided into 3 segments: segment A or initial segment (the most proximal to the testis) showing a smooth outer surface and, on section, a uniform lumen and absence of mucosal invaginations; segment B (1.5-4 cm) showing a smooth outer surface and, on section, small cavities in the mucosa; and segment C or ampulla (3-4 cm), which was easily recognisable because of the cerebriform pattern on its outer surface. Segment A showed the usual histological pattern reported in studies of the human ductus deferens. Segment B consisted of mucosa, muscularis mucosae, submucosa, muscular coat and adventitia. The epithelial lining formed multiple branched invaginations in the lamina propria and submucosa giving rise to glandular structures. The lumen of the duct and the glands were lined by the same cell types: (1) basal cells; (2) mitochondrion-rich cells; and (3) columnar cells with the ultrastructural features of glycoprotein-secreting cells. The latter cells could be classified into 3 subtypes suggesting different stages of development: (a) with abundant mitochondria; (b) with abundant rough endoplasmic reticulum; and (c) with abundant secretory granules. Segment C or the ampulla showed the same histology as segment B except for the presence of many diverticula in the ampulla.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1992

Bilateral mucinous cystadenocarcinoma of the testis and epididymis.

We describe an intratesticular mucinous cystadenocarcinoma in a 59-year-old man. The tumor was bilateral and appeared in the right testis and the left epididymis. The testicular tumor was a well-demarcated nodule, 3.5 cm in diameter, that extended from the lower testicular pole (close to the albuginea) to the epididymis compressing the corpus and infiltrating the cauda. The contralateral tumor, a 2.5-cm nodule located in the corpus epididymidis, compressed the ductus epididymidis. Both tumors consisted of multiple cavities varying in size, separated from one another by connective tissue septa that were incompletely lined by a columnar pseudostratified epithelium. The epithelial cells immunostained positively for carcinoembryonal antigen and comprised two cell types: cells showing a hyperchromatic nucleus, located in the basal portion of the cell, abundant rough endoplasmic reticulum, apical vacuoles, and numerous microvilli; and mucous cells. The cystic lumen showed a mucous content and sloughed epithelial cells. The differential diagnosis and histogenesis of these tumors is discussed.

Cystadenocarcinoma↗

PubMed1992

Testicular granulosa cell tumor of the adult type.

A testicular granulosa cell tumor of the adult type was studied in a 61-year-old man with a history of diabetes and urinary bladder carcinoma. The tumor was composed of three areas, each with a distinctive histologic pattern: solid, cystic, and cordlike. Most of the tumor cells in the three patterns had a round to ovoid euchromatic nucleus with one or two large nucleoli and scanty cytoplasmic organelles, mainly mitochondria and rough endoplasmic reticulum. These cells showed slight immunopositivity for vimentin and no immunostaining for cytokeratins. Occasionally, elongated nuclei displaying membrane infoldings were observed. Pleomorphic nuclei were rare. The number of mitotic figures was low. Differential aspects of testicular and ovarian granulosa cell tumors are discussed.

Granulosa Cell Tumor↗

PubMed1992

Primary testicular lesions in the twisted testis.

OBJECTIVE: To investigate primary lesions in twisted testes. DESIGN: The histologic study of testicular specimens obtained from men who had suffered testicular torsion. SETTING: The conditions required for material selection were the knowledge of the exact time of torsion and the presence of recognizable seminiferous epithelium cells. PATIENTS: Two hundred eighteen testicular torsions treated in La Paz Hospital, Madrid, Spain, from 1970 to 1990. MAIN OUTCOME MEASURES: After rejection of specimens that did not fulfill the conditions for selection, 109 biopsy and orchidectomy specimens from pubertal and adult males were studied to determine if primary lesions are superimposed to lesions secondary to anoxia. RESULTS: The following primary tubular lesions were found: (1) focal hypospermatogenesis (5 biopsies and 1 orchidectomy specimen; these testes showed degree I, II, or III anoxic lesions); (2) hypoplastic zones with only immature and hyperplastic Sertoli cells (3 orchidectomy specimens with degree III lesions); (3) zones of Sertoli-cell-only tubules that only contained a normal amount of mature appearing Sertoli cells (5 orchidectomy specimens with degree III lesions); and (4) intratubular calcifications (1 orchidectomy specimen with degree III lesions). In two cases with degree III lesions, more than one primary testicular lesion could be observed. CONCLUSIONS: An important number of twisted testes bear primary lesions that might had been involved in torsion development. The real percentage is probably even higher than that found in this study (14%) because the material obtained (biopsies) in many cases was insufficient to ensure complete exploration and because primary lesions are not recognizable in areas with pronounced anoxic lesions.

Adolescent↗

PubMed1991

Apical mitochondria-rich cells in the human epididymis: an ultrastructural, enzymohistochemical, and immunohistochemical study.

An ultrastructural, enzymohistochemical, and immunohistochemical study of the ductus epididymis in normal men was undertaken to investigate the characteristics of the apical mitochondria-rich cells (AMRCs). These cells, which differ morphologically from the principal cells (PCs), appear in isolation in the caput epididymidis (5.8 +/- 1.7 cells per cross-sectional duct) and only occasionally in the corpus epididymidis. The morphologic appearance of AMRCs varies from slender cells extending from the basement membrane to the lumen to apical cells without apparent contact with the basement membrane. The former display a round pale nucleus located in the middle of the epithelium; the apical cells have a dark nucleus, which, surrounded by a narrow cytoplasmic band, protrudes into the lumen. The cytoplasm of AMRCs is electron-dense and contains numerous mitochondria surrounded by rough endoplasmic reticulum cisternae. In the apical portion, there are lysosomes, vesicles with an electron-dense granule, and vacuoles showing a variable size and content. The stereocilia are shorter and less numerous than those of the PCs. The AMRCs are similar to the PCs in the intensely positive reaction for the enzymatic activity acid phosphatase, as well as in the lack of reaction for alkaline phosphatase and phosphorylase activities. AMRCs differ from PCs in: (1) a more intense reaction to the enzymatic activities ATPase, NADP, and succinic dehydrogenease, (2) a more intense immunostaining by AE1/AE3 and Ks4.62 anti-cytokeratin antibodies, and anti-estradiol receptor protein (D5) antibodies, and (3) a lower staining affinity for epithelial membrane antigen (EMA) antibodies. No positive immunostaining for the anti-cytokeratin Ks8.6 antibodies was observed in either AMRCs or PCs.

Adenosine Triphosphatases↗

PubMed1991

Ultrastructure of the aging human testis.

The ultrastructure of the progressive testicular involution with advancing age in men is reviewed. There is no definite age at which testicular involution begins, and the onset and severity of testicular lesions are subjected to pronounced individual variations. Hormone studies also indicate great individual variations, and subtle changes in both the testis and the pituitary develop progressively with age. Testicular size, sperm quality, and numbers of all germ cell types, Sertoli cells, and Leydig cells decrease with age. The volume occupied by the seminiferous tubules decreases, whereas that occupied by the testicular interstitium remains constant. The most frequent histological pattern of the aging testis is a mosaic of different seminiferous tubule lesions, varying from tubules with complete, although reduced, spermatogenesis, to completely sclerosed tubules. The tubules with complete spermatogenesis may show numerous morphological abnormalities in the germ cells, including multinucleation. Abnormal germ cells degenerate causing Sertoli cell vacuolation. These vacuoles correspond to dilations of the extracellular spaces resulting from the premature exfoliation of germ cells. Degenerating cells that are phagocytosed by the Sertoli cells give rise to an accumulation of lipid droplets in the Sertoli cell cytoplasm. The loss of germ cells begins with the spermatids, but progressively affects the earlier germ cell types, and tubules with maturation arrest at the level of the spermatocytes or spermatogonia are observed. The Sertoli cells show morphological abnormalities such as dedifferentiation, mitochondrial metaplasia, and multinucleation. Germ cell loss is associated with thickening of the tunica propria. When all seminiferous epithelial cells have disappeared, only an intensely collagenized tunica propria with myoid cells remains (sclerosed tubules). The Leydig cells progressively dedifferentiate with a decrease in the quantity of both smooth endoplasmic reticulum and mitochondria, together with an accumulation of lipid droplets, crystalline inclusions, and residual bodies, and formation of multinucleate cells. The development of tubular involution with age is similar to that observed after experimental ischemia, suggesting that vascular lesions may play an important role in age-related testicular atrophy.

Aging↗

PubMed1991

Immunohistochemical and quantitative study of interstitial and intratubular Leydig cells in normal men, cryptorchidism, and Klinefelter's syndrome.

Testicular specimens from normal men and men with cryptorchidism (CR) or Klinefelter's syndrome (KS) were taken, processed for light microscopy, and stained with the avidin-biotin peroxidase complex method for immunohistochemical detection of testosterone. The Leydig cells were classified by their morphology (normal, multivacuolated, and pleomorphic Leydig cells) and by their staining affinity for anti-testosterone antibodies (T-, T+, and T++ cells), and the average numbers of each cell type for each group of testes were calculated. Normal testes showed morphologically normal interstitial Leydig cells (96.0 +/- 10 per cent) and multivacuolated Leydig cells (4.0 +/- 1 per cent). Cryptorchid testes showed normal Leydig cells (85.8 +/- 11 per cent) and multivacuolated Leydig cells (14.2 +/- 2.3 per cent). Men with KS showed normal Leydig cells (78.9 +/- 9.1 per cent), multivacuolated Leydig cells (9.2 +/- 1.2 per cent), and pleomorphic Leydig cells (11.0 +/- 1.8 per cent). The percentage of T++ cells was higher in normal testes (29.4 +/- 2.1 per cent) than in CR (11.4 +/- 2.2 per cent) and KS testes (6.3 +/- 0.7 per cent). This suggests reduced functional Leydig cell activity in CR and KS. Multivacuolated Leydig cells showed weaker immunostaining than did normal Leydig cells in all the testicular groups. No immunostaining was shown by pleomorphic Leydig cells. Intratubular Leydig cells were only found in CR and KS. Immunostaining was weaker in intratubular Leydig cells than in interstitial Leydig cells. This suggests that intratubular location reduces functional activity of Leydig cells.

Adolescent↗

PubMed1991

Granular transformation of Sertoli cells in testicular disorders.

In order to study the granular transformation of Sertoli cells the following testicular specimens were reviewed: 58 postmortem biopsies from 21 children and 37 young adult males with normal histologic pattern; 165 biopsies from prepubertal cryptorchid testes; 38 biopsies and 18 surgical specimens from postpubertal-cryptorchid testes; bilateral biopsies from eight men with Del Castillo's syndrome, 14 men with retractile testes, and five men with obstructive azospermia; 17 bilateral and seven unilateral biopsies from 24 men with varicocele; seven unilateral biopsies plus five surgical specimens from 12 men with male pseudohermaphroditism; one biopsy and one surgical specimen from two men with macroorchidism; and the autopsy specimens from 28 adult men with acquired immunodeficiency syndrome (AIDS). Sertoli cells with eosinophilic granular cytoplasm were found in the testes of one prepubertal and four postpubertal cryptorchid males, two males with Del Castillo's syndrome, two males with retractile testes, four males with varicocele, two male pseudohermaphrodites, two males with macroorchidism, and one male with AIDS and interstitial orchitis. Histochemical and ultrastructural examination of granular Sertoli cells revealed that these cells accumulate secondary lysosomes and show scant cytoplasmic organelles. In the males with varicocele or retractile testes, these lysosomes were probably heterolysosomes that had degraded the germ cells and testicular fluid accumulated in the lumen of the ectatic seminiferous tubules of these testes. A similar mechanism is also probable in the male with interstitial orchitis that had caused germ cell destruction. In the other cases, in which the tubules showed reduced lumen and severe germ cell depletion, the abundant lysosomes are probably cytolysosomes. The development of these cytolysosomes might be related to the Sertoli cell dysgenesis present in these testes.

Adult↗

PubMed1991

Malignant fibrous histiocytoma of the larynx.

Malignant fibrous histiocytomas of the upper respiratory tract are rare, aggressive mesenchymal neoplasms. We report a case of a glottic malignant fibrous histiocytoma of the larynx on a 54 year old man. Only a few have been reported in the English literature. The clinical behaviour and degree of malignancy of these tumours cannot be predicted. Wide, aggressive excision of the tumour with a margin of normal tissue appears to be the treatment of choice. About two years after total laryngectomy the patient is well and free of disease.

Histiocytoma, Benign Fibrous↗

PubMed1991

[Leydig cell tumor: presentation of 3 new cases with a benign course].

Three cases of Leydig cell tumor are described. Patient ages were 27, 44 and 55 years, respectively. The first two patients consulted for a testicular mass and the third patient presented with gynecomastia, an incidental finding during the ultrasound work up of a hydrocele. Hormonal evaluation revealed a marked serum testosterone level in one case, whereas in another case it fell within the lower limits of normal ranges. No evidence of dissemination was observed in all patients. Treatment was by radical inguinal orchiectomy in all patients. The pathological analysis of the surgical specimens revealed Leydig cell tumor with no histologic evidence of malignancy. A follow-up of 32, 14 and 10 months, respectively, revealed no evidence of tumor recurrence in all patients. The clinical and histologic features and treatment of this disease process are described.

Adult↗

PubMed1990

Ossifying hemangioma of the temporal bone.

Intratemporal vascular tumors are more frequent than has previously been noted. Despite their small size, hemangiomas of the temporal bone are extremely aggressive and produce severe neural deficits. The term ossifying hemangioma is used to denote an intratemporal vascular tumor characterized by new bone formation, which is responsible for the typical honeycomb appearance of these tumors on high-resolution computed tomographic scans. Early resection offers the best chance for good facial recovery in patients with vascular tumors of the temporal bone involving the facial nerve. Our case report supports this observation and emphasizes the importance of incorporating these tumors in the differential diagnosis of patients with persistent facial paralysis.

Adult↗

PubMed1990

Congenital testicular lymphangiectasis in children with otherwise normal testes.

Two cases of testicular lymphangiectasis are reported, occurring in stillborns. The disease is a congenital malformation consisting of an abnormal expansive development of lymphatic vessels in both testes. Autopsy study revealed the absence of pulmonary, intestinal or systemic lymphangiectasis. The testes showed normal tubular development with normal germ cell numbers and also normal Leydig cell numbers. The epididymis and spermatic cord appeared normal. In contrast with the two previously reported cases of testicular lymphangiectasis, the present cases were not associated with cryptorchidism or other malformations.

Humans↗

PubMed1990

Sertoli cell types in the Sertoli-cell-only syndrome: relationships between Sertoli cell morphology and aetiology.

Histological study of testicular biopsies from infertile men showing Sertoli-cell-only tubules due to hypogonadotropic hypogonadism, cryptorchidism, oestrogen treatment, chemotherapy or Del Castillo's syndrome, revealed four types of Sertoli cells: (1) normal adult mature cells showing an indented nucleus, grossly triangular in shape with a prominent tripartite nucleolus; (2) immature cells with round regularly outlined nuclei and immature cytoplasm; (3) dysgenetic cells showing immature nuclei and a nearly mature cytoplasm with less developed cytoplasmic organelles; and (4) involuting cells with very irregularly outlined nuclei and a mature cytoplasm containing abundant lipid droplets and residual bodies and atypical inter-Sertoli junctional specializations. Testes from men with hypogonadotropic hypogonadism showed only immature Sertoli cells; cryptorchid testes showed dysgenetic cells and occasional normal cells; and after treatment with oestrogens or chemotherapy the testes showed involuting cells and normal cells. The testes of men with Del Castillo's syndrome could be classified into three groups, according to the Sertoli cell type present: mature, dysgenetic and involuting cells. This finding suggests that Del Castillo's syndrome may be due to at least three different aetiologies.

Adult↗

PubMed1990

Laminin, type IV collagen, and fibronectin in normal and cryptorchid human testes. An immunohistochemical study.

An immunohistochemical study of laminin, type IV collagen, and fibronectin was carried out in the testes of normal men and in the cryptorchid and contralateral scrotal testes of cryptorchid men from 2 to 40 years of age. The integrated optical density (IOD) per unit area of the lamina propria was measured in the immunostained sections. Fibronectin was found throughout the thickness of the lamina propria of the seminiferous tubules and in the interstitial connective tissue. No differences between normal and cryptorchid testes were found. Laminin was observed in the innermost part of the lamina propria of the seminiferous tubules and surrounding the endothelium of blood capillaries from infancy. No differences were found between normal and cryptorchid testes in the prepubertal period. In adult cryptorchid testes, laminin formed more numerous and deeper invaginations towards the seminiferous epithelium than in normal adult testes. Type IV collagen appeared throughout the thickness of the lamina propria of normal testes as well as in the wall of interstitial blood vessels. From infancy, the lamina propria of seminiferous tubules, but not blood vessel walls, showed lesser immunostaining for type IV collagen and a lower IOD of this component than did control tests from men of the same age. No differences between unilateral and bilateral cryptorchidism were found. The contralateral scrotal testes of cryptorchid males showed intermediate immunostaining for type IV collagen between that of normal control testes and that of cryptorchid testes. These findings suggest that the lamina propria of seminiferous tubules is lesioned at an early age in both cryptorchid and contralateral scrotal testes of cryptorchid men.

Adolescent↗

PubMed1990

Quantitative and ultrastructural alterations in the lamina propria and Sertoli cells in human cryptorchid testes.

A quantitative and ultrastructural study was performed on biopsies of human cryptorchid testes to investigate lesions in the lamina propria and Sertoli cells. Prepubertal cryptorchid testes (1-9 years of age) were classified into four groups: Type 1, testes with minimal lesions; Type II, testes with a moderate decrease in tubule diameter and spermatogonal number; Type III, testes with Sertoli cell hypoplasia and a marked reduction in tubule diameter and spermatogonal number; and Type IV, testes with Sertoli cell hyperplasia and a variable reduction in spermatogonal number. An increase in thickness of the lamina propria was found in Type II and III testes from 5 years of age onwards. These testes also showed a decrease in both the average number of peritubular cells per cross-sectioned tubule and in the average nuclear volume of these cells. Most of the postpubertal cryptorchid testes from 13- to 18-year-old youths presented a prepubertal pattern suggestive of delayed testicular maturation. Postpubertal testes from 19- to 27-year-old men were classified into three types: Type A testes showed complete spermatogenesis, mature Sertoli cells and no lesions in the lamina propria; Type B testes showed isolated spermatogonia, mature Sertoli cells, and a marked thickening of the lamina propria; and Type C testes showed isolated spermatogonia, hyperplasia of immature Sertoli cells, and a slightly thickened lamina propria. Maturation of the lamina propria was always associated with maturation of the Sertoli cells. Thickening of the lamina propria was associated with peritubular cell alterations consisting of decreases in the nuclear volume (average and total per testis) of peritubular cells and increases in the number of these cells per cross-sectioned tubule. The three types of adult cryptorchid testes appear to be the postpubertal transformation of Type 1 testes (Type A), Type II and Type III testes (Type B), and Type IV testes (Type C).

Adult↗

PubMed1990

Carcinosarcoma of the spermatic cord.

The first case of carcinosarcoma in the spermatic cord is reported in a 40-year-old man. The tumor was a 2.5 X 2 cm pseudoencapsulated formation located in the connective tissue of the spermatic cord among the blood vessels. Light microscopy examination of the neoplasm revealed two different histological patterns: epithelial and sarcomatous. Mitoses and atypias were infrequent in both types of areas. The epithelial cells formed papillary and gland-like structures stained with PAS, Hale and mucicarmine stains, and showed positive reaction for immunohistochemical demonstration of both keratin and epithelial membrane antigen. The lumen content of the gland-like structures reacted positively for the carcinoembryonic antigen. Electron microscopy revealed that the epithelial cells were joined by junctional complexes and displayed numerous short microvilli. The sarcomatous areas consisted of spindle cells embedded in a ground substance that occasionally presented myxoid changes. Mast cells and focal calcifications were seen. Sarcomatous cells showed positive reaction for vimentin but not for the other histochemical and immunohistochemical techniques mentioned above. The ultrastructure of sarcomatous cells was similar to that of epithelial cells except for the occurrence of small desmosomes instead of junctional complexes. The differential diagnosis with adenomatoid tumor and malignant mixed mesothelioma is discussed.

Adult↗

PubMed1990

Idiopathic hematoma of the epididymis: presentation of three cases.

Three cases of idiopathic hematoma are reported for the first time. The disease presented with clinical symptoms of epididymitis and was unsuccessfully treated with antibiotics. The persistence of the symptoms and the suspicion of tumor led to the removal of the lesioned epididymides. The etiology of these hematomas and their differential diagnosis in relation with other benign processes of the epididymis are discussed.

Adult↗