case_images: PMC9942209_01
case_images: (a) USG shows heterogeneous hypoechoic areas with diffuse involvement of testis, (b) intraoperative photograph shows pus collection in the scrotal cavity and epididymis, (c) gross photograph of resected orchidectomy specimen showing necrotic and shrunken testis (marked with asterix) surrounded by thickened fibrotic and yellowish-white deposits in paratesticular region (marked with arrow). USG: Ultrasonography
case_images: IJU-39-58-g002.jpg
case_images: PMC9942209_02_IJU-39-58-g002.jpg
case_images: F2
case_images: Intraoperative findings revealed a thickened edematous sac filled with pus and necrotic testis [Figure 2b]. Firm yellowish nodular deposits were observed in the right testis and epididymis [Figure 2c].
case_images: PMC9942209_02
case_images: (a) USG shows heterogeneous hypoechoic areas with diffuse involvement of testis, (b) intraoperative photograph shows pus collection in the scrotal cavity and epididymis, (c) gross photograph of resected orchidectomy specimen showing necrotic and shrunken testis (marked with asterix) surrounded by thickened fibrotic and yellowish-white deposits in paratesticular region (marked with arrow). USG: Ultrasonography
case_images: IJU-39-58-g002.jpg
case_images: PMC9942209_02_IJU-39-58-g002.jpg
case_images: F2
case_images: Intraoperative findings revealed a thickened edematous sac filled with pus and necrotic testis [Figure 2b]. Firm yellowish nodular deposits were observed in the right testis and epididymis [Figure 2c].
case_images: (a) Photomicrograph of case with xanthogranulomatous epididymitis showing interstitial proliferation of foamy histiocytes resulting in compression of the epididymal tubules (marked with arrow; H and E, x20), (b) high-power view demonstrating presence of plasma cells, and lymphocytes amidst collections of foamy histiocytes (H and E, x40), (c) immunohistochemical stain for CD68 highlighting the foamy histiocytes (x20)
case_images: IJU-39-58-g003.jpg
case_images: PMC9942209_02_IJU-39-58-g003.jpg
case_images: F3
case_images: On microscopic examination, sheets of foamy histiocytes were observed in the epididymis that were admixed with plasma cells, eosinophils, and lymphocytes [Figure 3a and b]. Immunohistochemical stain for CD68 was performed that highlighted the foamy histiocytes [Figure 3c].
case_images: PMC9942209_03
case_images: Representative image from XGEO case showing (a) areas of extensive fibrosis replacing the parenchymal tissue (H and E, x4), (b) fat necrosis evident in paratesticular region (H and E, x20), (c) XGI (marked with arrow) extending to the dermoepidermal junction of the scrotal skin (H and E, x4), (d) widespread Ischemic necrosis involving testicular parenchyma and neutrophilic abscess formation (marked with arrow; H and E, x4). XGEO: Xanthogranulomatous epididymitis/orchitis, XGI: Xanthogranulomatous inflammation
case_images: IJU-39-58-g004.jpg
case_images: PMC9942209_03_IJU-39-58-g004.jpg
case_images: F4
case_images: There were areas of fibrosis and lymphoid aggregates [Figure 4a]. The inflammation was extending up to the dermoepidermal junction of the scrotal skin with fat necrosis in surrounding adipose tissue [Figure 4b and c]. Extensive ischemic necrosis of testicular parenchyma was noted along with the presence of neutrophilic abscesses [Figure 4d].
case_images: PMC9942209_04
case_images: A case of focal XGE-low power photomicrograph showing a well-circumscribed nodular deposit of foamy macrophages replacing the epididymal tubules (boundaries marked with asterix; H and E, x2). XGI: Xanthogranulomatous inflammation
case_images: IJU-39-58-g005.jpg
case_images: PMC9942209_04_IJU-39-58-g005.jpg
case_images: F5
case_images: Section examined from the epididymal nodule revealed collection of foamy histiocytes admixed with few lymphocytes and plasma cells [Figure 5].