Spermiophages on testicular fine needle aspiration cytology: A rare finding

Macrophages usually reside in the testicular interstitial tissues and are normally not found within the seminiferous tubules. However, in certain cases of male infertility, the macrophages are activated and can then be found within the tubules where they can ingest spermatozoa and are labeled as "spermiophages." FNAC was performed in a 36 year male with history of primary infertility. On microscopy, smears made from right testis were indicative of hypospermatogenesis. On the contrary, smears made from the left testis were very cellular showing Sertoli cells and the entire spectrum of normal spermatogenesis. Also seen were many isolated spermiophages. The cytological impression given for the left testis was normal spermatogenesis with numerous spermiophages. Thus the patient fell in the category of obstructive azoospermia (OA). According to currently adopted hypothesis, macrophages carry ingested sperm heads with some antigenic components to the basal capillaries which may result in the formation of autoantibodies against the spermatozoa. This situation may further diminish the chances of fertility in men. The origin of these spermiophage cells is unknown. Although commonly reported in semen and epididymal biopsies, they have not been reported to occur on testicular fine needle aspiration cytology (FNAC). In our case, no sperms were found on semen examination which were easily picked up on testicular FNAC indicating usefulness of the latter in the diagnosis of cases of male infertility and eliminating the need for a testicular biopsy.