Reinke crystals

Reinke crystals are rod-like cytoplasmic inclusions which can be found in Leydig cells of the testes.[1] Occurring only in adult humans and wild bush rats, their function is unknown.[2]

Ovarian stromal tumors having a predominant pattern of fibroma or thecoma but also containing cells typical of steroid hormone-secreting cells were reported. Some of the tumors were classified as luteinized thecomas because the steroid cells resembled lutein cells and lacked crystalloids of Reinke. Others were classified as stromal Leydig cell tumors as seen in tumors of the testes because Reinke crystalloids were identified in the steroid cells. The stromal Leydig tumors occurred at an average age of 61 years and were associated with ovarian hyperandrogenism which led to virilization in some cases, endometrial hyperplasia in other cases, and endometrial hyperplasia with carcinoma in the rest of the cases. Luteinized thecomas and stromal Leydig cell tumors are indistinguishable except for the presence of crystalloids of Reinke in the latter. In view of the prolonged search that is necessary to find these structures in some stromal Leydig cell tumors and their well-known absence in the majority of testicular Leydig cell tumors, it is reasonable to assume that an unknown proportion of tumors in the luteinized thecoma category are unrecognized stromal Leydig cell tumors.[3][4][5]

Another ovarian tumor where Reinke crystalloids were noted is the Brenner tumour, an epithelial-stromal ovarian tumor distinguishable by nests of transitional epithelial cells (urothelial) with longitudinal nuclear grooves (coffee bean nuclei) in abundant fibrous stroma.[6][7]

Also recall that the "coffee bean nuclei" are the nuclear grooves exceptionally pathognomonic to the sex cord stromal tumor, the ovarian granulosa cell tumor, with the fluid-filled spaces Call–Exner bodies between the granulosa cells.[8]

They are large enough to be seen in an optical microscope and can be visualized using Giemsa, trichrome, Gram, and PAS stains.[9] Reinke crystals are rare in normal testes, but are found in approximately one third of all Leydig cell tumours.[10]

These crystals are named after the German anatomist Friedrich Berthold Reinke.[11]

References
  1. Young, Barbara; Woodford, Phillip; O'Dowd, Geraldine (2013-10-09). Wheater's Functional Histology: A Text and Colour Atlas (FUNCTIONAL HISTOLOGY (WHEATER'S)) (Kindle Locations 9938-9939). Elsevier Health Sciences UK. Kindle Edition.
  2. Young, Barbara; Woodford, Phillip; O'Dowd, Geraldine. Wheater's Functional Histology: A Text and Colour Atlas (2014), Sixth Edition, Elsevier, Philadelphia, p. 344.
  4. Zhang, J.; Young, R. H.; Arseneau, J.; Scully, R. E. (1982). "Ovarian stromal tumors containing lutein or Leydig cells (luteinized thecomas and stromal Leydig cell tumors)--a clinicopathological analysis of fifty cases". International Journal of Gynecological Pathology. 1 (3): 270–285. doi:10.1097/00004347-198203000-00004. ISSN 0277-1691. PMID 6309683. S2CID 22113962.
  5. Sood, Neelam; Nigam, Jitendra Singh; Goyal, Geetika; Ranjan, Reeta (2014-08-12). "Virilizing Ovarian Fibrothecoma with Minor Sex Cord Elements in a 13 Year Old Girl: a Rare Case". Pediatric Reports. 6 (3): 5447. doi:10.4081/pr.2014.5447. ISSN 2036-749X. PMC 4292058. PMID 25635214.
  7. Ahr, A.; Arnold, G.; Göhring, U. J.; Costa, S.; Scharl, A.; Gauwerky, J. F. (July 1997). "Cytology of ascitic fluid in a patient with metastasizing malignant Brenner tumor of the ovary. A case report". Acta Cytologica. 41 (4 Suppl): 1299–1304. doi:10.1159/000333524. ISSN 0001-5547. PMID 9990262.
  9. Mesa Hector, Gilles Scott, Smith Sophia, Dachel Susan, Larson Wendy, Manivel J. Carlos, The Mystery of the Vanishing Reinke Crystals, Human Pathology (2015), doi: 10.1016/j.humpath.2015.01.004
  10. T. M. Ulbright and R. H. Young. AFIP Atlas of tumour pathology. Tumours of the testis and adjacent structures. Fourth series fascicle 18, Silver Spring, Maryland: ARP Press, 2013, p. 271–286.
  11. "Friedrich Berthold Reinke". Whonamedit.com. Retrieved 12 February 2015.
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