Difference between revisions of "Testicular torsion"

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DDx:
DDx:
*Testicular tumour (e.g. [[germ cell tumour]]).<ref>{{Cite journal  | last1 = Kao | first1 = CS. | last2 = Zhang | first2 = C. | last3 = Ulbright | first3 = TM. | title = Testicular hemorrhage, necrosis, and vasculopathy: likely manifestations of intermittent torsion that clinically mimic a neoplasm. | journal = Am J Surg Pathol | volume = 38 | issue = 1 | pages = 34-44 | month = Jan | year = 2014 | doi = 10.1097/PAS.0b013e31829c0206 | PMID = 24061519 }}
*Testicular tumour (e.g. [[germ cell tumour]]).<ref name=pmid24061519>{{Cite journal  | last1 = Kao | first1 = CS. | last2 = Zhang | first2 = C. | last3 = Ulbright | first3 = TM. | title = Testicular hemorrhage, necrosis, and vasculopathy: likely manifestations of intermittent torsion that clinically mimic a neoplasm. | journal = Am J Surg Pathol | volume = 38 | issue = 1 | pages = 34-44 | month = Jan | year = 2014 | doi = 10.1097/PAS.0b013e31829c0206 | PMID = 24061519 }}</ref>
</ref>
*[[Germ cell neoplasia in situ]] (incidental finding).
*[[Intratubular germ cell neoplasia]] (incidental finding).


===Grading===
===Grading===
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- Epididymis with intratubular necrotic debris.
- Epididymis with intratubular necrotic debris.
- Changes compatible with testicular torsion.
- Changes compatible with testicular torsion.
- Negative for intratubular germ cell neoplasia or malignancy.
- NEGATIVE for germ cell neoplasia in situ (intratubular germ cell neoplasia).
- NEGATIVE for malignancy.
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Revision as of 23:53, 15 March 2016

Testicular torsion is rotation of the testis resulting in a reduced or absent blood flow with subsequent ischemia.

General

Clinical:

  • Pain.

Treatment:

  • Surgery.

Gross

  • Brown/black or red - due to necrosis/hemorrhage.

Image:

Microscopic

Features:

  • Intratubular hemorrhage.
  • Desquamation of germ cells.
  • +/-Necrosis of germ cells.

DDx:

Grading

Adapted from Mikuz:[2]

Grade Features
1 intertubular edema, limited blood extravasation, desquamation of germ cells
2 diffuse intertubular hemorrhage, focal necrosis of the germ cells
3 diffuse infarction of parenchyma

Sign out

Right Testicle, Orchiectomy:
- Testis with diffuse intratubular hemorrhage and focal desquamation 
  of germ cells.
- Epididymis with intratubular necrotic debris.
- Changes compatible with testicular torsion.
- NEGATIVE for germ cell neoplasia in situ (intratubular germ cell neoplasia).
- NEGATIVE for malignancy.

See also

References

  1. Kao, CS.; Zhang, C.; Ulbright, TM. (Jan 2014). "Testicular hemorrhage, necrosis, and vasculopathy: likely manifestations of intermittent torsion that clinically mimic a neoplasm.". Am J Surg Pathol 38 (1): 34-44. doi:10.1097/PAS.0b013e31829c0206. PMID 24061519.
  2. Mikuz, G. (1985). "Testicular torsion: simple grading for histological evaluation of tissue damage.". Appl Pathol 3 (3): 134-9. PMID 3842075.