肉芽腫性睾丸炎の1例

Abstract

A 29-year-old man visited our clinic because of painful swelling of the left scrotal contents, pain from the inguinal to buttock area on the same side and high fever. He has history of cystitis one month prior to this visit. On physical examination, the right testis and epididymis were enlarged as a single mass of elastic hard consistence with partial adhesion with the covering scrotal skin. Spontaneous pain was striking. The spermatic cord and the prostate gland were also swollen and tender on pressure. Leukocytosis and WBC in the urinary sediment were present. The removed specimen showed the central area of the testis being uniformly greyish-white. The tunica albuginea was markedly thickened and partly adherent with the skin where abscess formation was noted. This abscess was positive for E. coli but negative for the tubercle bacilli. Histologically, proliferation of the epithelioid cells in the seminiferous tubuli and germ cell aplasia were main changes compatible with granuloma. Other findings were thickened arterioles, thrombotic changes of the small veins, interstitial round cell infiltration, acid-fast substance in the macrophages. The epididymis showed nonspecific chronic inflammation. The granulomatous change was found advanced even to the spermatic cord. Granulomatous orchitis has been rarely reported in Japan.