184
LETTERS TO THE EDITOR
Happily, these points are thoroughly (nay, exhaustively) discussed in Wright and to which the monomaniacal Or dedicated quantifier can reDair. N*A’ and M ’QmN Department of Histopathology Royal P&tgradua& Medical School London WI.?0”
REFERENCES 1. Bullough WS. Mitotic activity in tissues of dead mice, and tissues kept
in Dhysioioj$cai salt solutions. ExplCeN Res 1950; 1: 410420. 2. Liewskv MF. In v i m studies of cell oroliferation in turnours. Eur J C k e r 1665; 1 2 281-287. 3. Dcnekamp J, Kallman RF. In vivo and in virro labelling of animal tumours with tritiated thymidine. Cell Tissue Kiner 1973; 6:217-227. 4. Simnett JD,Heppleston AG. Cell renewal in the m o w lung. The influence of sex. strain and age. Lab Invesr 1966; 15: 1793-1801 5. Wright NA, Alison M. The biology of epithelialcell populations, 1984, VOI. 1, Clarendon press, Oxford.
CARCINOMA IN SZTU OF THE TESTIS IN INFERTILE MEN In their publication on so-called carcinoma in situ indicate the precancerous character of this lesion, (CIS),’Nistal et al. discussed the possibility that CIS however, and also to distinguish it from germ cell may occur focally in testes and thus under certain tumours spreading through the tubules, we reccircumstances escape detection by random biopsy. ommended using the term testicular intraepithelial In order to investigate the distribution of CIS, we neoplasia (TIN). This term does not prejudice the examined 127 testes with germ cell turnours.* Our future development of the lesion, and at the same investigationsrevealed that the tumour-free areas of time clearly distinguishes it from the infiltrating the testes were diffusely affected by CIS in only 40 germ cell tumours. VOLKERLOY per cent of the cases, while the distribution of CIS Institut f u r Pathologie was focal in the remaining 60 per cent of the cases. In Klinikum Steglitz our opinion these results, as those of Nistal et al., Hindenburgdamm 30 show clearly that a negative testicular biopsy 1000 Berlin 45 cannot allow an absolutely sure prediction of the future course. We therefore suggested that high-risk KLAUS-PETER DIECKMANN Urologische Poliklinik patients with negative biopsies be further clinically Klinikum Steglitz observed. This is supported by the increasing Hindenburgdamm 30 number of cases reported in which a germ cell 1000 Berlin 45 tumour develops despite a negative b i o ~ s yNistal .~ et al. wrote further that the testicular tubules affected by CIS form lobules. We likewise observed this growth pattern in our investigations of CIS in the REFERENCES proximity of germ cell tumours. In contrast to the arguments of Nistal er al., however, we are of the 1. Nistal M, Codesal I, Paniagua R. Carcinoma in sifu of the testis in opinion that the tubules do notform the lobules, but infertile men. A histological, immunocytochemical. and cytophotometric study of DNA content. J Parhol1989;159: 205-210. that the CIS spreads within the primary anatomical b y V, Wigand I, Dieckmann KP. Incidence and distribution of lobules of the testis, over a period sf time penetrates 2. carcinoma in siru in testes removed for germ cell tumour: possible other lobules via the rete, and in this manner apinadequacy of random tsticular biopsy in detecting the condition. Histoparhology (in press). pears randomly distributed. In our opinion, the 3. Bannwart FB. Sigg C, Hedinger C. Morphologie, Biologie und theraterm CIS should be avoided, since it is definitively peutische Konsquenzcn der atypischen Kcimzellen d s Hodens. 261 not solely the precursor of carcinomas. In order to Haur 1988; 154: 861-866.
LETTERS TO THE EDITOR
Happily, these points are thoroughly (nay, exhaustively) discussed in Wright and to which the monomaniacal Or dedicated quantifier can reDair. N*A’ and M ’QmN Department of Histopathology Royal P&tgradua& Medical School London WI.?0”
REFERENCES 1. Bullough WS. Mitotic activity in tissues of dead mice, and tissues kept
in Dhysioioj$cai salt solutions. ExplCeN Res 1950; 1: 410420. 2. Liewskv MF. In v i m studies of cell oroliferation in turnours. Eur J C k e r 1665; 1 2 281-287. 3. Dcnekamp J, Kallman RF. In vivo and in virro labelling of animal tumours with tritiated thymidine. Cell Tissue Kiner 1973; 6:217-227. 4. Simnett JD,Heppleston AG. Cell renewal in the m o w lung. The influence of sex. strain and age. Lab Invesr 1966; 15: 1793-1801 5. Wright NA, Alison M. The biology of epithelialcell populations, 1984, VOI. 1, Clarendon press, Oxford.
CARCINOMA IN SZTU OF THE TESTIS IN INFERTILE MEN In their publication on so-called carcinoma in situ indicate the precancerous character of this lesion, (CIS),’Nistal et al. discussed the possibility that CIS however, and also to distinguish it from germ cell may occur focally in testes and thus under certain tumours spreading through the tubules, we reccircumstances escape detection by random biopsy. ommended using the term testicular intraepithelial In order to investigate the distribution of CIS, we neoplasia (TIN). This term does not prejudice the examined 127 testes with germ cell turnours.* Our future development of the lesion, and at the same investigationsrevealed that the tumour-free areas of time clearly distinguishes it from the infiltrating the testes were diffusely affected by CIS in only 40 germ cell tumours. VOLKERLOY per cent of the cases, while the distribution of CIS Institut f u r Pathologie was focal in the remaining 60 per cent of the cases. In Klinikum Steglitz our opinion these results, as those of Nistal et al., Hindenburgdamm 30 show clearly that a negative testicular biopsy 1000 Berlin 45 cannot allow an absolutely sure prediction of the future course. We therefore suggested that high-risk KLAUS-PETER DIECKMANN Urologische Poliklinik patients with negative biopsies be further clinically Klinikum Steglitz observed. This is supported by the increasing Hindenburgdamm 30 number of cases reported in which a germ cell 1000 Berlin 45 tumour develops despite a negative b i o ~ s yNistal .~ et al. wrote further that the testicular tubules affected by CIS form lobules. We likewise observed this growth pattern in our investigations of CIS in the REFERENCES proximity of germ cell tumours. In contrast to the arguments of Nistal er al., however, we are of the 1. Nistal M, Codesal I, Paniagua R. Carcinoma in sifu of the testis in opinion that the tubules do notform the lobules, but infertile men. A histological, immunocytochemical. and cytophotometric study of DNA content. J Parhol1989;159: 205-210. that the CIS spreads within the primary anatomical b y V, Wigand I, Dieckmann KP. Incidence and distribution of lobules of the testis, over a period sf time penetrates 2. carcinoma in siru in testes removed for germ cell tumour: possible other lobules via the rete, and in this manner apinadequacy of random tsticular biopsy in detecting the condition. Histoparhology (in press). pears randomly distributed. In our opinion, the 3. Bannwart FB. Sigg C, Hedinger C. Morphologie, Biologie und theraterm CIS should be avoided, since it is definitively peutische Konsquenzcn der atypischen Kcimzellen d s Hodens. 261 not solely the precursor of carcinomas. In order to Haur 1988; 154: 861-866.
