Fig. 1: Histomorphologic spectrum of aggressive testicular Leydig cell tumors (LCTs).

A Some aggressive LCTs had minimal cytologic atypia with markedly increased mitotic activity (case 5). B Apoptotic cells with condensed eosinophilic cytoplasm, pyknosis, and karyorrhexis were common in LCTs with aggressive histologic features, as shown in the micrograph (case 5). C Some aggressive LCTs displayed striking cytologic atypia characterized by nuclear pleomorphism (case 12). Eosinophilic nuclear pseudoinclusions were also seen (inset C, case 12) D Rare aggressive LCTs showed focal spindling (case 10) and atypical mitotic figures (inset D, case 12). Please see “Materials and Methods” for a detailed description of the histopathologic features that define aggressive and nonaggressive LCTs.