Atypical germ cells of the testis. Comparative ultrastructural and immunohistochemical investigations.

It is uncertain whether the so called intratubular atypical germ cells (carcinoma in situ cells) demonstrable in the testicular tissue around different germ cell tumors and in testicular biopsies of patients with impaired fertility are identical with regard to their morphology and further development. Thus atypical germ cells of 18 patients with testicular germ cell tumors and of 3 patients with atypical germ cells in testicular biopsies without tumor were studied by electron microscopy and/or by immunohistochemistry. The atypical germ cells show characteristic alterations distinguishing them from normal germ cells, especially spermatogonia. However, there are no differences between atypical germ cells in the above mentioned groups. Immunohistochemical reactions are negative with anti-alpha-fetoprotein and anti-beta-human-chorionic-gonadotropin, but 6 of the 15 cases are positive with antiferritin. However, this positive reaction occurs in cases in different diagnostic groups. Atypical germ cells of the different groups cannot be distinguished by electron microscopy or immunohistochemical methods, but further investigations, including cell cultures, may provide more information.