Abnormal germ cells in maldescended testes: a study of cell density, nuclear size and deoxyribonucleic acid content in testicular biopsies from 50 boys.

We have studied the numerical density, nuclear size and deoxyribonucleic acid content of germ cells in consecutive testicular biopsies from boys with maldescended testes. Patient age ranged between 7.8 and 17.9 years. Of the biopsy specimens 16 (32 per cent) contained no germ cells, while in the remaining 34 specimens the number of germ cells per unit volume of tissue was considerably below normal. In all cases the mean nuclear size of the germ cells was above normal. The deoxyribonucleic acid distribution pattern of germ cell nuclei was abnormal in 17 of 19 cases investigated, exhibiting increases in the median and mean deoxyribonucleic acid content, and a higher fraction of cells with a deoxyribonucleic acid content above the normal diploid range. We conclude that germ cells in the cryptorchid testis are abnormal with respect to numbers but also in nuclear morphology, as indicated by increased size and deoxyribonucleic acid content. Thus, quantitative and qualitative changes of the germ cells may be of importance in impaired fertility associated with testicular maldescent. The significance of these observations in relation to the increased risk of development of germ cell neoplasia in maldescended testes remains to be investigated.