Testicular torsion

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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.