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Xanthogranulomatous epididymitis: clinical report and immunohistochemical analysis

Xanthogranulomatöse Epididymitis

Zusammenfassung

Die xanthogranulomatöse Epididymitis (XE) ist ein seltener nicht-neoplastischer Prozess mit Zerstörung von Gewebe, welches durch eine eindrucksvolle zelluläre Infiltration mit schaumigen Makrophagen, dichten Lymphozyten und Plasmazellen ersetzt wird. Wir berichten über einen 72-jährigen Mann mit der klinischen Anamnese einer inadäquat behandelten arteriellen Hypertonie, der bei uns mit einer seit 10 Tagen bestehenden schmerzhaften Tumormasse rechts im Bereich des Skrotums vorstellig wurde. Bei der physikalischen Untersuchung wurde ein Eiter sezernierendes, hyperämisiertes und ödematöses Skrotum bei normaler Körpertemperatur festgestellt. Die Tumormarker für maligne Hodenerkrankungen waren negativ. Die Ultraschalluntersuchung (US) des rechten Hodens zeigte ein ödematös geschichtetes Skrotum sowie ein heterogenes Areal mit schlecht definierter Abgrenzung im Hoden und Nebenhoden. Es bestand eine minimale Hydrocele, der rechte Funikulus hatte einen normalen Durchmesser ohne Ödem oder andere pathologische Formationen. Die Progression der klinischen Befunde, der US und auch der Farb-US zusammen mit den negativen Tumormarkern ergaben letztlich die Indikation zur chirurgischen Sanierung. Es wurde eine Orchiepididymektomie rechts nach entsprechender präoperativer Therapie durchgeführt. Die Histologie bestätigte die Diagnose einer XE.

Summary

Xanthogranulomatous epididymitis is an uncommon non-neoplastic process with destruction of tissue and replacement by striking cellular infiltration of foamy macrophages, dense lymphocytes and plasma cells. We report on a 72-year-old man with a clinical history of inadequately treated arterial hypertension, who presented with a right scrotal mass associated with right scrotal pain for 10 days. Physical examination revealed pyogenic discharge from the hyperemic and edematous scrotum, with normal body temperature. Testicular tumor markers were normal. Ultrasonography (US) of the right testis showed edematous scrotal layers and a heterogeneous area of poorly defined margins within the testis and epididymis. There was minimal hydrocele, and the right funiculus was of normal diameter with no edema or pathologic formation. The progression of clinical findings, inflammatory parameters, US and color Doppler US findings with negative testicular tumor markers indicated surgical treatment. After preoperative treatment, right orchiepididymectomy was performed. Histology confirmed the diagnosis of xanthogranulomatous epididymitis.

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Correspondence to Zlatko Hrgovic.

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Persec, Z., Bulimbasic, S., Persec, J. et al. Xanthogranulomatous epididymitis: clinical report and immunohistochemical analysis. Wien Klin Wochenschr 120, 366–369 (2008). https://doi.org/10.1007/s00508-008-0991-8

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  • DOI: https://doi.org/10.1007/s00508-008-0991-8

Keywords

  • Epididymis
  • Xanthogranulomatous infection
  • Clinical treatment
  • Immunohistochemical analysis