Testicular Morphology in Hypogonadotropic Hypogonadism After the Abuse of Anabolic Steroids
Hypogonadism in men results from the failure of the testes to produce physiological levels of testosterone and a normal number of spermatozoa due to a disruption of the hypothalamic-pituitary-testicular axis.
An example of secondary hypogonadism as a result of anabolic steroid abuse is presented with the case report of a man who committed suicide after a history of aggressive behavior and physical abuse of his wife.
The weight of normally developed adult testis in Caucasian men is 21.6 ± 0.4 g (right testis) and 20 ± 0.4 g (left testis). The mean testicular diameter of the longest axis is 4.6 cm (range 3.6– 5.5 cm), the shortest is 2.6 cm (range 2.1–3.2 cm). The testicular volume is between 15 to 25 mL.
As the model of measuring is not described, it is not known if the data include epididymis, ductus deferens and tunica vaginalis, but we assume that the testes were measured without the other parts which are usually sent together for a pathological biopsy examination.
A low-specific immunochemical analysis revealed a very high level of total testosterone (serum 109.8 nmol/L; urine 81.2 nmol/L). A more accurate analysis confirmed an overdose of synthetic anabolic steroids.
The autopsy revealed shrunken testicles, with more than 30% of parenchymatous sclerosis, absent spermatogenesis, and very few Leydig cells detected only by immunohistochemistry.
The weight of the right testicle (without the epididymis, ductus deferens and tunica vaginalis) was 6.85 g, and the left testicle 6.66 g. The dimensions of the testicles in the longest and shortest axis were: 3.2 × 2.7 cm (right testis) and 3.0 × 2.9 cm (left testis).
Macroscopically visible degenerative changes with sclerosis of more than 30%of the displayed cut surface in both formalin fixed testicles were apparent. The remaining parts were of adequate macroscopic morphology, but the histological examination revealed large areas of hyalinization and atrophy of the seminiferous tubules, with practically absent spermatogenesis. The tubular basement membranes were thickened, and the tubular lumina contained only Sertoli cells or were completely obliterated. Only rarely, singular Leydig cells were detected using immunohistochemistry for inhibin, melan A and calretinin.
Alibegović A. Testicular morphology in hypogonadotropic hypogonadism after the abuse of anabolic steroids. Forensic Science, Medicine and Pathology 2018. Testicular morphology in hypogonadotropic hypogonadism after the abuse of anabolic steroids
Hypogonadism in men results from the failure of the testes to produce physiological levels of testosterone and a normal number of spermatozoa due to a disruption of the hypothalamic-pituitary-testicular axis.
An example of secondary hypogonadism as a result of anabolic steroid abuse is presented with the case report of a man who committed suicide after a history of aggressive behavior and physical abuse of his wife.
The weight of normally developed adult testis in Caucasian men is 21.6 ± 0.4 g (right testis) and 20 ± 0.4 g (left testis). The mean testicular diameter of the longest axis is 4.6 cm (range 3.6– 5.5 cm), the shortest is 2.6 cm (range 2.1–3.2 cm). The testicular volume is between 15 to 25 mL.
As the model of measuring is not described, it is not known if the data include epididymis, ductus deferens and tunica vaginalis, but we assume that the testes were measured without the other parts which are usually sent together for a pathological biopsy examination.
A low-specific immunochemical analysis revealed a very high level of total testosterone (serum 109.8 nmol/L; urine 81.2 nmol/L). A more accurate analysis confirmed an overdose of synthetic anabolic steroids.
The autopsy revealed shrunken testicles, with more than 30% of parenchymatous sclerosis, absent spermatogenesis, and very few Leydig cells detected only by immunohistochemistry.
The weight of the right testicle (without the epididymis, ductus deferens and tunica vaginalis) was 6.85 g, and the left testicle 6.66 g. The dimensions of the testicles in the longest and shortest axis were: 3.2 × 2.7 cm (right testis) and 3.0 × 2.9 cm (left testis).
Macroscopically visible degenerative changes with sclerosis of more than 30%of the displayed cut surface in both formalin fixed testicles were apparent. The remaining parts were of adequate macroscopic morphology, but the histological examination revealed large areas of hyalinization and atrophy of the seminiferous tubules, with practically absent spermatogenesis. The tubular basement membranes were thickened, and the tubular lumina contained only Sertoli cells or were completely obliterated. Only rarely, singular Leydig cells were detected using immunohistochemistry for inhibin, melan A and calretinin.
Alibegović A. Testicular morphology in hypogonadotropic hypogonadism after the abuse of anabolic steroids. Forensic Science, Medicine and Pathology 2018. Testicular morphology in hypogonadotropic hypogonadism after the abuse of anabolic steroids
