Testicular fine-needle aspiration in infertile men - Correlation of cytologic pattern with biopsy histology

Open testicular biopsy is the standard method for histopathologic assessmen t of spermatogenesis. The need for testis biopsy has been questioned with t he increased success of minimally invasive techniques such as fine-needle a spiration (FNA) mapping. This study examines whether FNA can provide cytolo gic information equivalent to histologic patterns by correlating diagnoses from testis FNA cytology with biopsy histology. Men (n = 87) who had underg one both diagnostic FNA mapping and open testis biopsy in the evaluation of infertility were identified. Biopsies were assessed by recognized histolog ic patterns of normal, hypospermatogenesis, early and late maturation arres t, and Sertoli cell only. FNA cytologic specimens were examined for adequac y and were classified similarly. Mixed patterns were also identified. The c orrelation between the two methods was 94%, with no differences among the d ifferent histologies. Discrepancies between cytology and histology were pri marily the result of inadequate sampling and evidence of mixed patterns on FNA mapping. FNA cytology is a minimally invasive method of obtaining testi cular tissue for diagnostic purposes. These data demonstrate that FNA cytol ogy can evaluate accurately all classically defined histologic types, and m ay have the potential to replace testis biopsy in the assessment of spermat ogenesis.