Testis & paratestis

Nonneoplastic lesions

Vasculitis



Last author update: 1 October 2014
Last staff update: 26 January 2021

Copyright: 2002-2024, PathologyOutlines.com, Inc.

PubMed Search: testicular vasculitis

Sean R. Williamson, M.D.
Page views in 2023: 3,091
Page views in 2024 to date: 916
Cite this page: Williamson S. Vasculitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/testisvasculitis.html. Accessed March 29th, 2024.
Definition / general
Clinical features
  • Can present with acute onset of pain and swelling, presumably related to intratesticular hemorrhage (Ir Med J 2006;99:27)
  • Systemic disease is frequently already present at the time of initial presentation of testicular vasculitis or develops shortly thereafter
  • Some cases, however, remain isolated to the testes with no evidence of progression to systemic disease (J Clin Pathol 1994;47:1121)
  • It is, therefore, unclear whether isolated testicular vasculitis represents an early site of involvement by systemic disease or a separate entity (World J Surg Oncol 2011;9:63)
  • Only several cases of isolated testicular vasculitis were reported in the literature and a presentation suggestive of a testicular neoplasm is even less common (J Clin Pathol 1994;47:1121)
  • Since testicular biopsy is contraindicated when malignancy is suspected, the diagnosis is usually reported postorchiectomy in these cases (ScientificWorldJournal 2010;10:1915, Urology 2003;61:1035)
  • Biopsy most likely diagnostic in patients with testicular symptoms (pain, enlargement or shrinking)
  • Wedge biopsy should contain capsule, tunica vasculosa and testicular parenchyma
Radiology images

Case #328

Testicular heterogeneous hypoechoic lesion

Case reports
  • 34 year old man with hypoechoic testicular lesion (Case #328)
Treatment
  • Treatment options are still debated and frequently hinge on individual factors which need to be carefully considered in each patient
  • Immunosuppressive therapy has been administered to some of the patients
  • In other cases, careful follow up to exclude progression to systemic disease was preferred (J Clin Pathol 1994;47:1121)
  • Some authors have even postulated that the excision of the affected organ might be curative, obviating the need for pharmacologic therapy (ScientificWorldJournal 2010;10:1915)
  • Close follow up, including serology, is recommended since the risk of progression to systemic disease is unknown (J Clin Pathol 1994;47:1121)
Gross description
Gross images

Case #328
Microscopic (histologic) description
  • Focal hemorrhage with early organization and small arteries around the area of hemorrhage (Case of the Week #328)
Microscopic (histologic) images

Case #328


Differential diagnosis
  • Although uncommon, isolated necrotizing testicular vasculitis remains in the differential diagnosis of hypovascular testicular lesions; long term follow up and additional research is needed in order to further elucidate the pathogenesis of isolated organ vasculitis and the subsequent risk of disease progression
Back to top
Image 01 Image 02