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NBME 22 Answers

nbme22/Block 3/Question#33

A 22-year-old man comes to the physician because of ...

47,XXY

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submitted by aesalmon(38),

Leydig cell hyperplasia, should also see fibrosis and hylinazation of the tubules but i'm not seeing it... ¯_(ツ)_/¯

meningitis  I think its there.. I thought it was the lighter red/pink material (hyaline material) And I thought the white streaks were the fibrosis like "streaked ovaries"in Turners. +  




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submitted by bubbles(31),

Has anybody found a good explanation for this histology? I genuinely have no idea what I'm looking at.

meningitis  This is common in Klinefelter.. think of the equivalent of Streaked ovaries seen in Turners. White streaks, red/pink material of hyaline, and hyperplasia of Leydig cells. Just remember: It doesn't look like normal structured testicle histology (No organized seminiferous tubules with Sertoli cells around) +5  
niboonsh  https://www.pathologyoutlines.com/topic/testisklinefelter.html these pictures are kinda similar +1  




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submitted by step1soon(11),

Testicular biopsies of adult males with Klinefelter syndrome are characterized by extensive fibrosis and hyalinization of the seminiferous tubules and hyperplasia of the interstitium; however, the tubules may show residual foci of spermatogenesis. Histologic findings may include small, firm testes with seminiferous tubular hyalinization; sclerosis; and atrophy with focal hyperplasia of mostly degenerated Leydig cells

http://www.pathopedia-india.com/Klinefelter_Syndrome.htm