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

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Abstract
Summary: 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 I, 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 spermato‐genesis, 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 I testes (Type A), Type II and Type III testes (Type B), and Type IV testes (Type C).