PMC3752856_01
Testicular ultrasound: The testis is large in size with heterogeneous echogenicity and poorly visualized outline
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F1
Testicular ultrasound examination confirmed the presence of bilateral hyperechogenic hypervascularized lesion; right: 8.6 cm x 3.5 cm; left: 8.4 cm x 5.5 cm [Figure 1].
Frozen sections: (a: left) The lesion was composed of sheets and nests separated by dense fibrous tissue (H and E, x200), (b: right) The individual cells were large round and polygonal cells with defined cell borders, abundant eosinophilic cytoplasm and round central nuclei (H and E, x400)
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F2
Nests of cells were separated by dense fibrous tissue [Figure 2].
Gross evaluation of orchiectomy specimen. Cut surface revealing a well-circumscribed, non-capsulated, solid, and lobulated brown lesion
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F3
Permanent histopathological and immunohistochemical evaluation: (a: upper left) Cells contain lipochrome pigments and show mild nuclear pleomorphism with absence of Reinke crystals and lack of mitotic activity (H and E, x400), (b: upper right) Fibrosis surrounding the eosinophilic polygonal cells and lymphoid aggregates (H and E, x200), (c: lower left) Patchy reactivity for synaptophysin (IHC, x200), (d: lower right) Positive reactivity to CD56 (IHC, x200)
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F4
Some lymphoid aggregates were seen [Figure 4]. Immunohistochemical analyses were performed [Figure 4].