Joual A, Rabii R, Guessous H, Benjelloun M, el Mrini M, Benjelloun S
Service d'urologie, CHU Ibn Rochd, Casablanca, Maroc.
Ann Urol (Paris). 2000 Jun;34(3):192-4.
In this study, a case has been reported involving a 66-year old male who was admitted for scrotal pain on the right side with possible testicular involvement, but with no associated urinary disorder. At physical examination, the right testicle was found to have increased in volume: this was further confirmed by ultrasonography, but the findings were insufficient to exclude the hypothesis of testicular cancer. An exploratory orchidectomy by upper inguinal route was therefore carried out, and histopathological examination showed the destruction of testicular tissue by several granulomas, and caseous necrosis with giant cells. Antibacterial chemotherapy was administered after an i.v. urography found no evidence of abnormality or urinary disorder, thereby eliminating an active site of genitourinary tuberculosis. This case shows the importance of considering testicular tuberculosis in the differential diagnosis of testicular enlargement in a region where this disease is endemic, despite the absence of systemic pulmonary and urinary signs of tuberculosis.
在本研究中，报告了一例病例，患者为66岁男性，因右侧阴囊疼痛入院，可能累及睾丸，但无相关泌尿系统疾病。体格检查发现右侧睾丸体积增大：超声检查进一步证实了这一点，但这些发现不足以排除睾丸癌的假设。因此，通过腹股沟上途径进行了探查性睾丸切除术，组织病理学检查显示睾丸组织被多个肉芽肿破坏，并伴有干酪样坏死和巨细胞。静脉肾盂造影未发现异常或泌尿系统疾病的证据后，给予了抗菌化疗，从而排除了泌尿生殖系统结核的活跃病灶。该病例表明，在这种疾病流行的地区，尽管没有肺结核和泌尿系统结核的全身症状，但在睾丸肿大的鉴别诊断中考虑睾丸结核的重要性。
