Congenital testicular deficiency. II. Defective Sertoli cell differentiation in hypogonadism of so-called obscure origin.

Abstract

WE (1, 2) have recently called attention to certain forms of congenital testicular disease associated with androgen deficiency. In one type (1) there was a complete absence of spermatogonia (germinal aplasia) with preservation of Sertoli and Ley dig cells. In another form (2) a rudimentary cryptorchid testis was entirely devoid of germinal, Sertoli and Leydig cells. It was composed essentially of small solid tubules containing only undifferentiated cells. The purpose of the present communication is to record still another variety of testicular dysgenesis. In this instance Leydig cells are absent, but the Sertoli cells show variable development ranging from complete absence in some tubules to full differentiation in others. At the same time, spermatogonia are preserved, although there is no evidence of germ cell maturation. Tubular fibrosis is conspicuous and could easily obscure the primarily congenital nature of the testicular lesion.