CYTOMORPHOLOGICAL SPECTRUM OF TESTICULAR FINE NEEDLE ASPIRATION CYTOLOGY IN CASES OF AZOOSPERMIA

Abstract

Objective: To determine the frequency of morphological spectrum of FNAC in cases of azoospermia.

Study Design: Descriptive, cross sectional study.

Setting: Department of Pathology, Combined Military Hospital, Multan, from 15^th December 2016 to 15^th June 2017.

Materials & Methods: A total of 112 patients were selected according to inclusion and exclusion criteria, that is   age range between 20-50 years with history of azoospermia for at least 1 month on the basis of semen analysis. Patients with already known diagnosis, patients with history of orchiectomy or patients with history of radiotherapy and chemotherapy were excluded. Patients were informed about the procedure, their consent for the procedure and for participating in our study were taken. Procedure was performed under spermatic cord block, slides were prepared and reported by consultant histopathologist.

Results: Mean age was 31.6 years with standard deviation of ±5.91. All of the patients were married. Only 10 out of 112 patients had history of diabetes mellitus and only 5 out of 112 patients had family history of azoospermia. Mean BMI was 22.74 with standard deviation of ±2.95. The mean duration of marriage was 4.62 years with standard deviation of ±3.09 and mean duration of azoospermia was 2.69 years with standard deviation of ±2.23. Among the patients, 109 out of 112 patients had diagnostic FNAC finding while 3 out of 109 patients yielded unsatisfactory results. Among the cytomorphological patterns, hypospermatogenesis was the most common pattern which was observed in 32.1% of the patients. Normal spermatogenesis was seen in 18.8 percent of patients, maturation arrest was seen in 19.6% patients, sertoli cells only was seen in 26.8% patients. 2.7% patients had unsatisfactory sample. A non-signiï¬cant statistical association was seen among age, disease duration, diabetes and family history with p value > 0.05.

Conclusion: This study was conducted to ascertain cytomorphological patterns of testicular tissue among targeted population and to determine the frequencies of these patterns in our population. This study concluded that FNAC testis is a satisfactory procedure for evaluating the cause of azoospermia and FNAC sample in 97.3% of the patient’s was satisfactory for evaluation. Hypospermatogenesis was the most common cytomorphological pattern seen in 32.1% of the patients which was followed by sertoli cells examine only which was seen in 26.8% of the patients. Non-significant association was found between patient’s age, duration of disease, family history or diabetes mellitus with any of the cytomorphological pattern.

Keywords: Azoospermia, Cytomorphology, FNAC.