Seminal fluid analysis and fine-needle aspiration cytology in the diagnosis of carcinoma in situ of the testis.

Surgical biopsies and fine-needle aspirates of peri-tumoural seminiferous tubules were taken from freshly-excised orchidectomy specimens. In addition, patients with suspected germ cell tumour provided a peri-operative sample of seminal fluid. All three tissue preparations were investigated using flow cytometry, immunochemistry for placental-like alkaline phosphatase and enzymochemistry for alkaline phosphatase. Biopsy and fine-needle aspiration cytology provide the greatest diagnostic accuracy for carcinoma-in-situ using these techniques. Seminal fluid analysis did not provide a satisfactory diagnostic yield in the series of patients presented. A seminal plasma placental-like alkaline phosphatase immunoassay failed to discriminate CIS because of the high level of background germ cell alkaline phosphatase.