我们报道了一名 27 岁男性，因高促性腺激素性性腺功能减退症、睾酮水平低下和无精子症而转诊。 23 岁时，他接受了左侧睾丸 0.7 厘米低回声结节的切除术。病理诊断为间质细胞瘤。右侧睾丸超声检查发现三个结节，最大的0.6厘米。四年后，右侧睾丸的结节仍然存在，较大的结节被切除。活检显示小管结周区仅含有支持细胞。间质内可见间质细胞弥漫性结节性增生。病理诊断为支持氏综合征伴间质细胞严重增生。通过睾酮治疗，LH 下降，结节消失。此后，中断治疗后，LH 升高，并且结节两次重新出现。恢复睾酮治疗后，结节再次消失，表明间质细胞增生依赖于慢性 LH 刺激。

We report a 27 -year-old male referred because of hypergonadotropic hypogonadism with low testosterone and azoospermia. At 23 years of age, he underwent an excision of a hypoechoic 0.7 cm nodule of the left testicle. The pathological diagnosis was a Leydig cell tumor. In the right testicle, there were three nodules at ultrasound, the biggest measuring 0.6 cm. Four years later, the nodules in the right testicle were still present and the larger nodule was excised. The biopsy showed tubules with only Sertoli cells in the perinodular zone. Diffuse and nodular hyperplasia of the Leydig cells was found in the interstitium. The pathological diagnosis was Sertoli syndrome with severe hyperplasia of the Leydig cells. With testosterone therapy, LH decreased, and the nodules disappeared. Thereafter, upon interrupting therapy, LH increased, and the nodules reappeared in two occasions. Resuming testosterone treatment, the nodules disappeared again, suggesting a Leydig cell hyperplasia dependent on chronic LH stimulation.