case_images: PMC3350072_01
case_images: Scrotal ultrasound images with color Doppler showing decreased blood flow to the left testicle (a) and right testicle (b). Both images are in the sagittal view.
case_images: CRIM.UROLOGY2011-465353.001.jpg
case_images: PMC3350072_01_CRIM.UROLOGY2011-465353.001.jpg
case_images: fig1
case_images: Scrotal ultrasound with color Doppler showed poor blood flow within the left testicle, and bowel or fat was noted superior to the left testicle; see Figure 1(a). A scrotal ultrasound revealed no blood flow, Figure 1(b), and physical examination revealed an edematous right testicle that was very tender to palpation.
case_images: Hematoxylin and eosin stains (100x). Testicular specimen showing thrombotic vasculopathy, intravascular papillary endothelial hyperplasia (IPEH), and recanalization.
case_images: CRIM.UROLOGY2011-465353.002.jpg
case_images: PMC3350072_01_CRIM.UROLOGY2011-465353.002.jpg
case_images: fig2
case_images: Pathologic evaluation again showed benign testis with acute interstitial hemorrhage and focal atrophy; see Figure 2.
case_images: Hematoxylin and eosin stains (600x). Skin biopsy demonstrating fibrin thrombus in the vessel lumen consistent with a clot (black arrow) and fibrin deposition in a postcapillary venule wall with surrounding granulocytic debris, consistent with a leukocytoclastic vasculitis (white arrow).
case_images: CRIM.UROLOGY2011-465353.003.jpg
case_images: PMC3350072_01_CRIM.UROLOGY2011-465353.003.jpg
case_images: fig3
case_images: Initially a diagnosis of warfarin-induced skin necrosis was considered, but the skin biopsy of the anterior abdominal wall contained thrombotic vasculopathy with leukocytoclastic vasculitis; see Figure 3.