A case of complete androgen insensitivity syndrome presenting with incarcerated inguinal hernia: an immunohistochemical study Panagiotis Papanastasopoulos,

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A case of complete androgen insensitivity syndrome presenting with incarcerated inguinal hernia: an immunohistochemical study Panagiotis Papanastasopoulos, M.D, Antonios Panagidis, M.D., Dionysios Verras, M.D., Maria Repanti, Ph.D., George Georgiou, M.D. Fertility and Sterility Volume 92, Issue 3, Pages 1169.e11-1169.e14 (September 2009) DOI: 10.1016/j.fertnstert.2009.05.030 Copyright © 2009 American Society for Reproductive Medicine Terms and Conditions

Figure 1 (A) Gross specimens, in which the testicle on top of the field is the necrotic left one (thin arrow), and the bottom is the viable right testicle (thick arrow) (B) Immature solid seminiferous tubules (thin arrows) within which a few spermatogonia (arrowhead) can be recognized. The stroma is edematous and contains small clusters of Leydig cells (thick arrows) (stain: hematoxylin and eosin). Fertility and Sterility 2009 92, 1169.e11-1169.e14DOI: (10.1016/j.fertnstert.2009.05.030) Copyright © 2009 American Society for Reproductive Medicine Terms and Conditions

Figure 2 Immature seminiferous tubules show strong cytoplasmic staining for antimüllerian hormone (AMH), but the spermatogonia (short arrow) and Leydig cells (long arrow) are negative for AMH (EnVision/DAB). Fertility and Sterility 2009 92, 1169.e11-1169.e14DOI: (10.1016/j.fertnstert.2009.05.030) Copyright © 2009 American Society for Reproductive Medicine Terms and Conditions

Figure 3 Immature seminiferous tubule show strong nuclear staining for SRY-box–containing gene 9 (SOX-9) (arrow). The spermatogonia (arrowhead) and Leydig cells (circled) show no immunoreactivity for SOX-9 (EnVision/DAB). Fertility and Sterility 2009 92, 1169.e11-1169.e14DOI: (10.1016/j.fertnstert.2009.05.030) Copyright © 2009 American Society for Reproductive Medicine Terms and Conditions

Figure 4 (A) Spermatogonia (arrows) within immature seminiferous tubules show focal nuclear staining for prostaglandin D synthase (EnVision/DAB) (B) Sertoli cells (arrows) within immature seminiferous tubules show weak cytoplasmic staining for prostaglandin D synthase (EnVision/DAB). Fertility and Sterility 2009 92, 1169.e11-1169.e14DOI: (10.1016/j.fertnstert.2009.05.030) Copyright © 2009 American Society for Reproductive Medicine Terms and Conditions

Figure 5 (A) Immature seminiferous tubules (arrows) show no immunoreactivity at all for androgen receptors (En Vision/DAB) (B) The seminiferous tubule (arrow) of normal testicular tissue (positive control) demonstrates strong nuclear immunoreactivity for androgen receptors (En Vision/DAB). Fertility and Sterility 2009 92, 1169.e11-1169.e14DOI: (10.1016/j.fertnstert.2009.05.030) Copyright © 2009 American Society for Reproductive Medicine Terms and Conditions