Necrotising granulomatous epididymo-orchitis

Case contributed by Dr Andrew Ryan


Testicular mass lesion on ultrasound

Patient Data

Age: 20 years
Gender: Male

Right testis

Circumscribed but unencapsulated, firm, pale lesion, 20 x 10 mm, centred on the hilum of the testis and focally extending into the testicular parenchyma.


Low power (fig. 1, 40x) - An unencapsulated inflammatory lesion involving the testicular hilum and parenchyma, with residual normal parenchyma (left) and paratesticular/cord structures (right).

Medium power (fig. 2, 100x) - Angular zones of brightly eosinophilic necrosis with palisading inflammatory cells, including abundant epitheliod histiocytes (activated macrophages).

High power (fig. 3 and 4, 400x) - Zones of necrosis with palisading epithelioid histiocytes (fig. 3) and scattered multinucleate giant cells (fig. 4).

Case Discussion

Necrotising granulomatous inflammation is most frequently the result of infection, particularly mycobacterial infections, but can also be seen in the setting of other inflammatory conditions, e.g. granulomatosis with polyangiitis (previously known as Wegener granulomatosis). 

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Case information

rID: 58946
Published: 14th Mar 2018
Last edited: 24th May 2018
System: Urogenital
Inclusion in quiz mode: Included

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