PMC6192136_01
Axial computed tomography (CT) image, depicting a heterogeneous right testicle, with associated right scrotal fluid collection (long arrow) and inflamed right epididymis (short arrow).
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This was further evaluated with a contrasted computed tomography (CT) of the chest, abdomen, and pelvis, which revealed a complex right-sided scrotal fluid collection (Figure 1) in addition to an enlarged and heterogeneous prostate, an enlarged juxtaesophageal lymph node, and right lung apical nodular scarring.
Opened scrotal sac with the exposed testicle (T) and enlarged and nodular epididymis (E).
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Grossly, the epididymis was enlarged (6.0 x 1.7 x 1.5 cm; Figure 2), with caseating necrosis and miliary deposits within the testicle and epididymis (Figure 3).
Bisected epididymis (E) and testicle (T), depicting a yellow-tan exudate and miliary deposits (arrows).
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Grossly, the epididymis was enlarged (6.0 x 1.7 x 1.5 cm; Figure 2), with caseating necrosis and miliary deposits within the testicle and epididymis (Figure 3).
H&E, 4x. Necrotizing granulomatous inflammation in a miliary-type distribution, with multinucleated giant cells (histiocytes, arrow), central necrosis (N), and intervening, uninvolved, normal testicular tubules (brackets).
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The histologic sections showed diffuse necrotizing granulomas, with giant cell formation in the scrotum, testis, and epididymis (Figure 4).