case_images: PMC6192136_01
case_images: Axial computed tomography (CT) image, depicting a heterogeneous right testicle, with associated right scrotal fluid collection (long arrow) and inflamed right epididymis (short arrow).
case_images: CRIID2018-7316097.001.jpg
case_images: PMC6192136_01_CRIID2018-7316097.001.jpg
case_images: fig1
case_images: This was further evaluated with a contrasted computed tomography (CT) of the chest, abdomen, and pelvis, which revealed a complex right-sided scrotal fluid collection (Figure 1) in addition to an enlarged and heterogeneous prostate, an enlarged juxtaesophageal lymph node, and right lung apical nodular scarring.
case_images: Opened scrotal sac with the exposed testicle (T) and enlarged and nodular epididymis (E).
case_images: CRIID2018-7316097.002.jpg
case_images: PMC6192136_01_CRIID2018-7316097.002.jpg
case_images: fig2
case_images: Grossly, the epididymis was enlarged (6.0 x 1.7 x 1.5 cm; Figure 2), with caseating necrosis and miliary deposits within the testicle and epididymis (Figure 3).
case_images: Bisected epididymis (E) and testicle (T), depicting a yellow-tan exudate and miliary deposits (arrows).
case_images: CRIID2018-7316097.003.jpg
case_images: PMC6192136_01_CRIID2018-7316097.003.jpg
case_images: fig3
case_images: Grossly, the epididymis was enlarged (6.0 x 1.7 x 1.5 cm; Figure 2), with caseating necrosis and miliary deposits within the testicle and epididymis (Figure 3).
case_images: H&E, 4x. Necrotizing granulomatous inflammation in a miliary-type distribution, with multinucleated giant cells (histiocytes, arrow), central necrosis (N), and intervening, uninvolved, normal testicular tubules (brackets).
case_images: CRIID2018-7316097.004.jpg
case_images: PMC6192136_01_CRIID2018-7316097.004.jpg
case_images: fig4
case_images: The histologic sections showed diffuse necrotizing granulomas, with giant cell formation in the scrotum, testis, and epididymis (Figure 4).