Granular changes in Sertoli cells in children and pubertal patients.

OBJECTIVE

To characterize lysosomes and histochemical function of granular Sertoli cells in developmental alterations.

DESIGN

Prospective and retrospective study.

SETTING

University hospital and research centers.

PATIENT(S): Nineteen infantile and pubertal patients undergoing testicular biopsy; four rat testes for lysosomal study.

INTERVENTION(S): CD-68, alpha-1-antitrypsin, vimentin, inhibin alpha subunit, and anti-mullerian hormone antibodies were evaluated. Morphometric measures in seminiferous tubules with and without granular Sertoli cells were obtained. Ultrastructural data of lysosomes in human and rat Sertoli cells were compared.

MAIN OUTCOME MEASURE(S): Quantification of mean diameter of seminiferous tubules, tubular fertility index, and germ and Sertoli cell indexes were obtained in human testis.

RESULT(S): Granular changes in Sertoli cells are due to the accumulation of large amounts of lysosomes. Vimentin immunoexpression in infantile and pubertal granular Sertoli cells was lower than in adjacent nongranular Sertoli cells. Inhibin was negative in granular cells. Anti-mullerian hormone-positive and -negative granular Sertoli cells were present within the same tubules.

CONCLUSION(S): The presence of early granular changes in Sertoli cells in childhood and pubertal cryptorchidic patients, associated with other developmental alterations, suggests an intense and irreversible dysfunction of phagocytosis in the granular Sertoli cells. These alterations might be considered primary and irreversible anomalies of Sertoli cells, which might be contributing factors in the infertility seen in these patients.