Pathology of the testis in acquired immunodeficiency syndrome

The acquired immunodeficiency syndrome (AIDS) is most often a sexually transmitted disease acquired via male genital tract secretions. We performed a retrospective controlled study of testicular tissue taken from 100 AIDS patients at autopsy to determine the nature and spectrum of macroscopic and microscopic changes associated with AIDS in the testis. The AIDS patients showed a highly significant constellation of findings that included lymphocytic infiltration, perivasculitis, germ-cell loss, interstitial fibrosis, decreased mean tubular diameter and increased mean tubular wall thickness. Only four cases showed evidence of testicular involvement with opportunistic infectious agents. In 48 cases gross pathological findings were present. Only four cases had histologically normal testes. We conclude that AIDS should be part of the differential diagnosis of testicular atrophy.