The Granulomatous Lesions of the Testicle and Epididymis

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Abstract
The authors present five cases of spermatic granulomas of the testicle and the epididymis with some discussion concerning the pathogenesis. It seems most probable that there is a chemical type of reaction in response to the presence of sperm outside the normal pathways. The spermatic granuloma begins with an inflammatory or traumatic lesion that provides a means for the sperm to invade the tubular epithelial cell and then the stroma. The slowly degenerating spermatozoa reaching the peritubular and the interstitial spaces release an acid fast lipid which together with the granulocytic substance in the presence of hyalouronidase and other enzymes plays an important fole in further destruction of the sperm. There may be problems in the microscopic diagnosis of these granulomata and the confusion with the tuberculous lesion should be kept in mind. Testicular granuloma should be differentiated from a malignant tumour.

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