Hyalinization of the Seminiferous Tubules Associated with Normal or Failing Leydig-Cell Function. Microscopic Picture in the Testis and Associated Changes in the Breast12

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Abstract
Biopsies of testes and breasts from 19 patients who presented the picture of hyalinized seminiferous tubules associated with high urinary gonadotrophins have been studied in detail and compared with material from men regarded as normal. The primary defect in the testes lies in the seminiferous tubules, in which progressive sclerosis of the lamina propria and basement membrane and retardation of spermatogenesis occurs. The end result of this process is progressive and complete disappearance of all germinal and Sertoli cells and complete hyalinization of the tubules. Ley dig cells present a variable picture. In most testes, they show an apparent, but probably not actual, increase with a tendency to form large clumps. Fibroblasts and fat cells, are increased markedly in most testes and the impression is distinct that these types are increasing at the expense of Leydig cells. From a cytological standpoint the latter present a variable picture but in most instances they appear to be undergoing functional failure. It is possible to correlate the condition of the Leydig cells with the clinical condition of the patients and, in general, with the output of 17-ketosteroids. The stromal and parenchymal changes in the breasts can be correlated in some, but not all, cases with the gross appearance of the breasts. In general, an increase in the amt. and density of the stromal elements is the most constant finding. It is presumed that the changes in the breasts are related to a disturbance in the metabolism of steroid hormones subsequent to failure of the Leydig cells.