PMC8383176_01
Enhanced computed tomography of the scrotum showed a nodular hyperdense shadow in the right epididymis (arrow).
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Enhanced computed tomography of the scrotum showed a nodular hyperdense shadow with a diameter of approximately 23 mm on the right epididymis, with significant heterogeneous enhancement on the enhanced scan (Figure 1).
Pathological biopsy of the right epididymis showed infiltration of plasma cells, lymphocytes, and a few neutrophils with occlusive vasculitis changes in the tissue (HE, x40) (A). Immunostains showed a markedly increased number of IgG4+ plasma cells as well as an increased IgG4+/IgG+ ratio (IgG4 immunostain, x40) (B).
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Pathological biopsy of the right epididymis showed infiltration of plasma cells, lymphocytes, and a few neutrophils with occlusive vasculitis changes in the tissue (Figure 2A). IgG4+ plasma cells stained positive, with an IgG4/IgG ratio of more than 40% and more than 30 IgG4+ plasma cells per high-power field (Figure 2B).
Timeline of diagnosis, treatment, and prognosis in this case.
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The timeline of diagnosis, treatment, and prognosis for this case is shown in Figure 3.