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Fine needle aspiration biopsy of azoospermic testes. Could it replace histologic biopsy?
M A Abdulla1, A L al-Salim, A al-Juwaiser
1Department of Pathology, Faculty of Medicine, Kuwait University, P.O. Box 24923, Code # 13110, Safat, Kuwait. mabdulla@hsc.kuniv.edu.kw
Objective:
To evaluate the possibility of replacing histologic biopsy of azoospermic testes by fine needle aspiration (FNA) for diagnostic and management purposes.
Study Design:
Twenty-seven patients were examined under general anesthesia, and 53 testes were biopsied by FNA. Fifty-four testes were biopsied for histologic examination. Histology and cytology of each testis were compared to assess the discrepancy or concordance between the diagnoses.
Results:
Twenty-seven testes showed complete concordance of cytology and histology, and 13 testes showed a mild degree of discrepancy. A severe degree of discrepancy was seen in 13 testes. In the majority of discrepant cases, FNA biopsy diagnosis was more sensitive in detecting evidence of full or advanced maturation. In one case of discrepancy, the histologic finding was Sertoli cells only, and cytology revealed focal full maturation. In vitro fertilization using sperm from this case was successful.
Conclusion:
FNA biopsy of testes in azoospermia is a fast, reliable and minimally traumatic method. The prospects for utilizing FNA biopsy material in assisted and microassisted fertilization are promising.