Value of testis biopsy in the diagnosis of systemic amyloidosis.
OBJECTIVE
To evaluate testis biopsy as a diagnostic tool in systemic amyloidosis, to assess how amyloidosis affects testicular tissue, and to examine the relationship between testicular amyloidosis and infertility.


METHODS
Testicular biopsies from 72 patients with confirmed systemic amyloidosis were examined for amyloid deposition after Congo red and crystal violet staining. A rectal biopsy was also done in each case, and the results were compared with the testicular biopsy findings.


RESULTS
Testicular amyloid deposition was detected in 62 (86.1%) of 72 patients. Fifty-one (85%) of 60 patients with secondary amyloidosis, 11 (91.7%) of 12 patients with primary amyloidosis, and 28 (87.5%) of 32 patients with familial Mediterranean fever showed amyloid deposition in the testis. Rectal biopsies were positive in 40 cases (55.6%). Only 4 of the 62 patients with testicular amyloid showed normal spermatogenesis. The remaining 58 exhibited abnormal spermatogenesis, and 77.7% of patients had seconder infertility. Of 62 patients with positive testis biopsies, 30 had serum creatinine levels less than 1.5 mg/dL, and 29 patients with testicular amyloid manifested nephrotic syndrome.


CONCLUSIONS
The testis biopsy is a valuable and more sensitive method than rectal biopsy for diagnosing systemic amyloidosis. The results also showed that testicular amyloidosis causes infertility at a higher rate than expected.
Ozdemir
B Handan
BH
Department of Pathology, Başkent University Faculty of Medicine, Ankara, Turkey.
Ozdemir
O Gürhan
OG
Ozdemir
F Nurhan
FN
Ozdemir
A Ilhan
AI
D000328:Adult; D000686:Amyloidosis / Q000150:complications / Q000473:pathology*; D001706:Biopsy / Q000379:methods*; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009845:Oligospermia / Q000209:etiology / Q000473:pathology; D013091:Spermatogenesis; D013733:Testicular Diseases / Q000150:complications / Q000473:pathology*; D013737:Testis / Q000473:pathology*