Testicular scar
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Testicular scar | |
---|---|
Diagnosis in short | |
Testicular scar. H&E stain. | |
| |
Synonyms | scar of testis |
| |
LM | seminiferous tubules replaced by fibrosis (hyaline material with a relatively low cellularity and no nuclear atypia) +/-hemosiderin-laden macrophages, atrophic changes (see testicular atrophy) |
LM DDx | necrotic tumour, (residual) testicular tumour (e.g. germ cell tumour) |
Gross | tan brown or white, well-circumscribed |
Site | testis |
| |
Clinical history | +/-history of testicular tumour |
Prevalence | uncommon |
Blood work | unremarkable |
Prognosis | benign |
Clin. DDx | (residual) testicular tumour |
Testicular scar, also scar of testis, is a phenomenon that may arise in the context of treatment for a germ cell tumour[1] or result from the spontaneous regression of a (germ cell) tumour.[2]
General
- Well-reported uncommon finding.
- May result from the spontaneous regression of a (germ cell) tumour.[2]
- Can be the result of trauma, (a prior untreated) testicular torsion or infection.
Gross
- Tan-brown or white lesion.
- Well-circumscribed.
Microscopic
Features:
- Seminiferous tubules replaced by fibrosis.
- Hyaline material with a relatively low cellularity and no nuclear atypia.
- +/-Hemosiderin-laden macrophages.
- Atrophic changes[2] - see testicular atrophy.
DDx:
- Necrotic tumour.
- Germ cell tumour, e.g. seminoma.
- Regressed germ cell tumour - suggestive features:[2]
- Distinct scar +/-germ cell neoplasia in situ (GCNIS) +/-coarse calcifications (intratubular).
- Scar with prominent (small) blood vessels (weakly suggestive).
- Scar with lymphoplasmacytic inflammatory infiltrate (weakly suggestive).
Images
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TESTICLE, RIGHT, ORCHIECTOMY: - TESTICULAR SCAR REPLACING MANY OF THE SEMINIFEROUS TUBULES. - REMAINING SEMINIFEROUS TUBULES WITH ATROPHIC CHANGES. - BENIGN SPERMATIC CORD AND EPIDIDYMIS. - NO EVIDENCE OF RESIDUAL GERM CELL TUMOUR. - NEGATIVE FOR MALIGNANCY.
See also
References
- ↑ Ramsey S, Kerr G, Howard GC, Donat R (2013). "Orchidectomy after primary chemotherapy for metastatic testicular cancer". Urol. Int. 91 (4): 439–44. doi:10.1159/000350858. PMID 24021555.
- ↑ 2.0 2.1 2.2 2.3 Balzer BL, Ulbright TM (July 2006). "Spontaneous regression of testicular germ cell tumors: an analysis of 42 cases". Am. J. Surg. Pathol. 30 (7): 858–65. doi:10.1097/01.pas.0000209831.24230.56. PMID 16819328.