Honoré L H
Arch Surg. 1978 Jul;113(7):814-6. doi: 10.1001/archsurg.1978.01370190036005.
Nine cases of peritesticular fibrosis initially appeared to be enlargement of the testes. Seven patients under went orchiectomy and two had biopsy specimens taken of the grossly thickened tunica albuginea. In six patients, a hydrocele was present with intramural fibrosis and minimal chronic inflammation. Active epididymitis and chronic interstitial orchitis were present in two patients, with some spread of the inflammation into the fibrotic peritesticular tissues. One case, without associated hydrocele or epididymitis, showed dense fibrosis of the peritesticular tissues with focal edema, lymphangiectasis, and minimal perivascular round cell infiltration. This clinicopathological entity of diffuse peritesticular fibrosis is an unrecognized cause of benign testicular enlargement. The hypothesis is advanced that the primary process is a congenital hypoplasia of the peritesticular lymphatics progressing at various speeds into a state of chronic lymphedema and end stage noninflammatory fibrosis.
9例睾丸周围纤维化最初表现为睾丸肿大。7例患者接受了睾丸切除术，2例患者对明显增厚的白膜进行了活检取材。6例患者存在鞘膜积液，伴有壁内纤维化和轻度慢性炎症。2例患者存在急性附睾炎和慢性间质性睾丸炎，炎症部分蔓延至纤维化的睾丸周围组织。1例患者无相关鞘膜积液或附睾炎，表现为睾丸周围组织致密纤维化，伴有局灶性水肿、淋巴管扩张和轻度血管周围淋巴细胞浸润。这种弥漫性睾丸周围纤维化的临床病理实体是良性睾丸肿大的一个未被认识的原因。有人提出假说，认为原发性病变是睾丸周围淋巴管先天性发育不全，以不同速度发展为慢性淋巴水肿和终末期非炎性纤维化状态。
