Stereological estimates of nuclear volume in normal germ cells and carcinomain situof the human testis

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Abstract
Carcinoma in situ of the testis may appear many years prior to the development of an invasive tumor. Using point-sampled intercepts, base-line data concerning unbiased stereological estimates of the volume-weighted mean nuclear volume (nuclear .hivin.vv) were obtained in 50 retrospective serial testicular biopsies from 10 patients with carcinoma in situ. All but two patients eventually developed an invasive growth. Testicular biopsies from 10 normal adult individuals and five prepubertal boys were included as controls. Nuclear .hivin.vv in testicular carcinoma in situ was significantly larger than that of morphologically normal spermatogonia (2P = 1.0 .times. 10-19), with only minor overlap. Normal spermatogonia from controls had, on average, smaller nuclear .hivin.vv than morphologically normal spermatogonia in biopsies with ipsi- or contra-lateral carcinoma in situ (2P = 5.2 .times. 10-3). No difference in nuclear .hivin.vv was found in carcinoma in situ with or without co-existing invasion, and no characteristic pattern of nuclear .hivin.vv was disclosed by following the lesion in serial biopsies over time from individual patients. Estimation of nuclear .hivin.vv may represent an adjuvant tool in morphologically puzzling cases of testicular carcinoma in situ, but the prognostic value requires further evaluation in larger series of patients.