Testicular torsion

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

General

• Clinical diagnosis.

Clinical:

• Pain.

Treatment:

• Surgery.

Gross

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

Image:

• Testicular torsion (med.utah.edu).

Microscopic

Features:

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

DDx:

• Testicular tumour (e.g. germ cell tumour).
• Germ cell neoplasia in situ (incidental finding).

Grading

Adapted from Mikuz:

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

• Testis.
• Testicular abscess.
• Testicular trauma.
• Infarction.
• Ovarian infarct.
• Ovarian torsion.