Histopathology on Testicular Involvement of Leukemia with an Emphasis on Lymphatics

Wakasa, Haruki; Amano, Shigeru

doi:10.1620/tjem.123.147

Cited by 7 publications

(4 citation statements)

References 11 publications

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“…It is difficult to explain the exact reason for the high SWE values in testicular malignancies, as several factors such as the mitotic index or fibrosis of the capsule can theoretically affect stiffness measurements in the testis [ 5 ]. One hypothesis relates to the histologic background of hematologic malignancies in the testes, as these cases could show interstitial infiltration of leukemic cells [ 22 ]. Regarding the high SWE in testicular varicocele, thickened tubular basement membranes and increased deposition of interstitial fibrous tissue with germ cell atrophy were possible explanations noted in previous studies [ 23 , 24 ], and it was assumed that these findings might lead to increased stiffness on SWE [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Shear-wave elastography for the assessment of testicular involvement of hematologic malignancies in children and young adults: a feasibility study

Koh

Lee

et al. 2022

Ultrasonography

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This study aimed to assess the feasibility of shear-wave elastography (SWE) in testicular hematologic malignancy in children and young adults.Materials and Methods: A total of eight patients (mean age, 11.0 years; range, 0.8-20 years) with biopsy confirmed testicular hematologic malignancy between January 2018 and December 2020 were retrospectively evaluated. Multiparametric ultrasound examinations, including grayscale, color Doppler ultrasound (CDUS), and SWE, were performed. The stiffness was measured on the involved testicular area and contralateral normal parenchyma and if there was bilateral testicular involvement, the stiffness of involved area and adjacent normal echoic parenchyma was measured on one-sided testis. The Mann-Whitney U test was used for comparison of the stiffness.Results: On grayscale, the testicular lesions were noted as a solitary mass in one patient, multiple lesions in four patients, and diffuse involvement in three patients. On CDUS and SWE, all patients demonstrated increased vascularity, and the stiffness of the involved area was higher than the values of normal parenchyma (the involved area vs. normal parenchyma, 11.6 kPa [3.9-20.2 kPa] vs. 2.9 kPa [1.1-3.7 kPa], p= 0.003). The ratio of stiffness between the involved area and normal parenchyma was 3.4, ranging from 1.9 to 5.1. One patient showed decreased stiffness on follow-up SWE after treatment (initial; 7.0 mm3 vs. 1.0 mm3, 1 year later; 3.2 mm3 vs. 2.1 mm3, affected testis vs. normal testis). Conclusion:The increased testicular stiffness on SWE in children and young adults with hematologic malignancy suggests the possibility of testicular involvement.

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Section: Discussionmentioning

confidence: 99%

Shear-wave elastography for the assessment of testicular involvement of hematologic malignancies in children and young adults: a feasibility study

Koh

Lee

et al. 2022

Ultrasonography

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“…Wakasa et al histopathologically demonstrated that leukemic infiltration can be diffuse or in the form of patches in perivascular area and interstitium of the testis (7). In their study, presence of leukemic cells was shown in lumen of capillary structures and inside testicular lymphatics.…”

Section: Literature Review and Discussionmentioning

confidence: 99%

“…In their study, presence of leukemic cells was shown in lumen of capillary structures and inside testicular lymphatics. Leukemic cells may access intra-luminal site by migrating from interstitium into lumen of vessel (7). In a study conducted on lymphoma and leukemia patients with testicular infiltration, Mazzu et al observed enlargement in involved testis in all cases in US (8).…”

Section: Literature Review and Discussionmentioning

confidence: 99%

Testis Scintigraphy in a Patient with Acute Lymphoblastic Leukemia

Eren

Koç

Ören

et al. 2014

Mirt

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Acute lymphoblastic leukemia (ALL) is a pediatric malignancy associated with remissions and relapses. Common relapsing sitesare meninges, testis and ovary. Testicular scintigraphy is a highly specific modality used mainly in the differential diagnosis of testicular torsion and epidydimitis/epidydimo-orchitis. There is only one interesting image on leukemic infiltration with scrotal scintigraphy in the literature. The aim of this case presentation is to report that although the scintigraphic appearance of testicular torsion was observed in a patient with the diagnosis of ALL, testicular ALL infiltration was revealed in pathologic examination. Conflict of interest:None declared.

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“…Murine Leydig cells were shown to be capable of selectively binding lymphocytes to their surface in vitro, resulting in inhibition of their mobility (Rivenzon et al, 1974;Wekerle, 1981, 1982;Recarova et al, 1994). It has also been reported that the human testes are essentially the preferred sites of lymphoid leukemic cell infiltration (Kamiyama and Funata, 1976;Wakasa and Amano, 1977;Williams et al, 1978). Therefore, there is speculation that Leydig cell-dependent trapping of lymphocytes may be involved in the frequent involvement of the testis in lymphocytic leukemia (Born and Wekerle, 1982).…”

Section: Discussionmentioning

confidence: 99%

Mode of migration of normal lymphocytes inside murine testis

et al. 1998

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Background: Previous studies have shown that in murine experimental autoimmune orchitis (EAO), lymphocytes preferably infiltrate into (1) the testicular capsule near the rete testis, (2) the subcapsular interstitium away from the rete testis, and (3) the interstitium surrounding the tubuli recti and rete testis. Therefore, these three sites might provide tissue environments in which specific lymphocytes can easily gain access to testicular autoantigens. However, there is another possibility that infiltrating lymphocytes in the testis spontaneously accumulate at these three sites via the lymphatic flow inside this organ during EAO.Methods: To examine this possibility, normal lymphocytes were locally injected into the peripheral testis regions of recipient mice. Testes were then collected at various times for investigating the chronological pattern of lymphocytic migration inside the testes at a light microscopic level.Results: The injected lymphocytes first stayed in the lymphatic space around the seminiferous tubules and then moved to the subcapsular lymphatic space away from the rete testis. The lymphocytes accumulated under the testicular capsule and then gradually infiltrated into the adjacent capsular tissue. In the capsule, the cells surrounded the arteriolae and then accumulated in the capsular tissue near the rete testis. Thereafter, the cells finally left the testes through the lymphatics running in the spermatic cords. In the course of the lymphocytic drainage, it was noted that the injected lymphocytes appeared not to pass through the testicular interstitium around the tubuli recti and rete testis.Conclusions: The regional distributions of the testicular lymphocytes imply that the lymphatic flow in the testis may somewhat influence murine EAO pathology characterized by lymphocytic accumulation in (1) the testicular capsule near the rete testis and (2) the subcapsular interstitium away from the rete testis. However, the pathology exhibiting lymphocytic accumulation in (3) the interstitium around the tubuli recti and rete testis is independent on the intratesticular lymph flow. Anat. Rec. 251:152-160, 1998.

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Histopathology on Testicular Involvement of Leukemia with an Emphasis on Lymphatics

Cited by 7 publications

References 11 publications

Shear-wave elastography for the assessment of testicular involvement of hematologic malignancies in children and young adults: a feasibility study

Shear-wave elastography for the assessment of testicular involvement of hematologic malignancies in children and young adults: a feasibility study

Testis Scintigraphy in a Patient with Acute Lymphoblastic Leukemia

Mode of migration of normal lymphocytes inside murine testis

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