PMC8848033_01
Left scrotal ultrasound image where fluid-filled cystic areas are black foci (arrow) interspersed within the white solid mass.
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Tumor markers were not raised and scrotal ultrasound revealed a large diffuse heteroechoic mass in the left hemiscrotum, measuring 10.9 x 9.8 x 9.7 cm3 with areas of calcification and cystic change (Figure 1).
Contrast-enhanced computed tomography of the pelvis showing a large diffuse heterodense mass lesion in the left scrotum with heterogeneous enhancement (arrow) on contrast study.
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Contrast-enhanced computed tomography (CECT) showed similar findings in the left hemiscrotum with moderate heterogeneous enhancement on contrast study (Figure 2).
Specimen of the left testis showing a large solid, cystic mass with foci of yellowish discoloration (arrow).
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Grossly (Figure 3), the specimen of high inguinal orchiectomy weighed 560 g and measured 13 x 9 x 5 cm3.
Photomicrograph showing diffuse sheets of histiocytes (small arrow) and giant cells (big arrow).
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Microscopy showed complete replacement of the testicular parenchyma by diffuse sheets of histiocytes and giant cells with areas of old hemorrhage, suggestive of xanthogranulomatous inflammation (Figure 4).
Necrotic material was identified in cyst contents.
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A cystic change containing necrotic debris was identified (Figure 5).
Asteroid bodies (arrow) seen in the cytoplasm of giant cells.
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Asteroid bodies were noted in the cytoplasm of most of the giant cells (Figure 6).
The mononuclear as well as giant cells show diffuse and strong immunopositivity for CD68, suggestive of histiocytic origin.
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The xanthomatous histiocytes and giant cells were immunoreactive for CD68 (Figure 7).