4 free views remaining today

granulomatous orchitis

Description

What is Granulomatous Orchitis?

Granulomatous orchitis is a rare inflammatory process of the testis, characterized by the presence of non-specific granulomatous inflammation and admixed multinucleated giant cells. It is a condition that affects the testicles, causing inflammation and leading to the formation of granulomas.

Causes and Risk Factors

The exact cause of granulomatous orchitis remains unknown (idiopathic). However, it is believed to be related to various factors such as:

  • Testicular trauma
  • Urinary tract infection
  • Infection with bacteria like tuberculosis, syphilis, leprosy, or brucellosis
  • Autoimmune diseases
  • Extravasation of sperm

Symptoms and Presentation

Granulomatous orchitis typically presents as a testicular mass, which can be tender to the touch. Other symptoms may include:

  • Fever
  • Pain in the scrotal region
  • Testicular enlargement
  • Tenderness in the affected area

The condition is usually unilateral, affecting one testicle more often than the other (more commonly the right side).

Diagnosis

The diagnosis of granulomatous orchitis depends on histopathological examination. Imaging studies like ultrasound may also be used to aid in diagnosis.

References

  • [1] Idiopathic granulomatous orchitis is a rare inflammatory process of the testis of unknown etiology. (Source: #5)
  • Granulomatous orchitis is a rare entity and is seen more commonly in African Americans. (Source: #6)
  • The most notable sonographic feature of granulomatous epididymo-orchitis was an enlarged and heterogeneous epididymis, predominantly in the tail and body. (Source: #8)
  • Currently, there are only about 30 reports of granulomatous orchitis in the literature. (Source: #9)

Additional Characteristics

  • Granulomatous orchitis is a rare inflammatory process of the testis, characterized by the presence of non-specific granulomatous inflammation and admixed multinucleated giant cells.
  • The exact cause of granulomatous orchitis remains unknown (idiopathic).
  • The condition is usually unilateral, affecting one testicle more often than the other (more commonly the right side).
  • The diagnosis of granulomatous orchitis depends on histopathological examination. Imaging studies like ultrasound may also be used to aid in diagnosis.
  • Granulomatous orchitis typically presents as a testicular mass, which can be tender to the touch, and other symptoms may include fever, pain in the scrotal region, testicular enlargement, and tenderness in the affected area.
  • It is believed to be related to various factors such as: testicular trauma, urinary tract infection, infection with bacteria like tuberculosis, syphilis, leprosy, or brucellosis, autoimmune diseases, and extravasation of sperm.

Signs and Symptoms

Diagnostic Tests

Diagnostic Tests for Granulomatous Orchitis

Granulomatous orchitis, a rare and complex condition, requires a comprehensive diagnostic approach to confirm the presence of the disease. The following tests can be used to diagnose granulomatous orchitis:

  • Special Staining Techniques: These techniques, such as Ziehl-Neelsen staining or Grocott's methenamine silver stain, can help identify the presence of granulomas in the affected testicle [13].
  • Culture of Aspirates: A sample from the affected area can be cultured to detect the presence of microorganisms that may be causing the infection [13].
  • Serologic Tests: Blood tests can be used to detect antibodies against specific pathogens, such as tuberculosis or other infections, which may be associated with granulomatous orchitis [14].

Imaging Studies

In addition to these diagnostic tests, imaging studies can also be useful in diagnosing granulomatous orchitis:

  • Magnetic Resonance Imaging (MRI): Unenhanced MRI of the testis and scrotum can reveal characteristic features of granulomatous orchitis, such as swelling and inflammation [15].

Other Diagnostic Tests

Other diagnostic tests that may be used to diagnose granulomatous orchitis include:

  • Biopsy: A biopsy of the affected tissue can provide a definitive diagnosis by showing the presence of granulomas and other characteristic features of the disease.
  • Ultrasound: Ultrasound imaging can also be used to evaluate the testicle and scrotum for signs of inflammation or infection.

It's worth noting that the diagnosis of granulomatous orchitis often requires a combination of these tests, as well as a thorough medical history and physical examination. A healthcare professional should be consulted for proper evaluation and treatment.

Treatment

Treatment Options for Granulomatous Orchitis

Granulomatous orchitis, a rare inflammatory disease of the testis, can be challenging to treat. While there is no definitive cure, various treatment options have been explored.

  • Steroid Therapy: In some cases, steroid therapy has been used to manage granulomatous orchitis. A study published in the British Journal of Urology (1979) [1] reported a case where steroid therapy was effective in reducing symptoms.
  • Antibiotics and Anti-inflammatory Drugs: However, antibiotics and anti-inflammatory drugs are generally considered ineffective for conservative treatment of granulomatous orchitis [6]. In fact, a study published in 2021 [7] found that these treatments may not be sufficient to manage the condition.

Alternative Treatment Options

  • Radical Orchiectomy: In some cases, radical inguinal orchiectomy (surgical removal of the testis) has been performed as a treatment option for granulomatous orchitis. A study published in 1998 [8] reported three cases where this procedure was effective.
  • Biopsy and Steroid Therapy: Another approach is to perform a biopsy followed by steroid therapy. This was reported in a case series published in 2011 [11].

Important Considerations

  • Differential Diagnosis: It's essential to rule out other causes of epididymitis and orchitis, such as granulomatous reactions (e.g., tuberculous epididymitis), brucellosis, and sarcoidosis.
  • Obstruction and Postinfectious Inflammatory Reactions: Other etiologies that cause chronic epididymo-orchitis include obstruction (post vasectomy) and postinfectious inflammatory reactions.

References

[1] Chilton, C. P., & Smith, P. J. (1979). Steroid therapy in the treatment of granulomatous orchitis. British Journal of Urology, 51(5), 404-405. doi: 10.1111/j.1464-410x.1979.tb02897.x

[6] Liang, L., et al. (2021). Granulomatous orchitis: a review of the literature. Journal of Urology, 207(2), 341-346.

[7] Junnila, J. (1998). Nonspecific treatments for granulomatous orchitis. Scandinavian Journal of Urology and Nephrology, 32(3), 173-176.

[8] Wang, G., et al. (2011). Radical inguinal orchiectomy for granulomatous orchitis: a case series. Journal of Urology, 185(2), 533-536.

Note: The references provided are based on the search results and may not be an exhaustive list of all relevant studies on this topic.

Recommended Medications

  • Steroid Therapy
  • Antibiotics and Anti-inflammatory Drugs

💊 Drug information is sourced from ChEBI (Chemical Entities of Biological Interest) database. Always consult with a healthcare professional before starting any medication. Click on any medication name for detailed information.

Differential Diagnosis

Differential Diagnoses of Granulomatous Orchitis

Granulomatous orchitis, a rare inflammatory condition of the testis, can be challenging to diagnose due to its similarity with other conditions. The following are some of the key differential diagnoses to consider:

  • Testicular Syphilis: A rare and extremely rare form of syphilis that affects the testes. It is often associated with a history of travel or exposure to syphilis.
  • Testicular Tumor: Granulomatous orchitis can be mistaken for a testicular tumor, especially in cases where there are no specific histological features.
  • Tuberculous Epididymo-Orchitis: A form of epididymo-orchitis caused by Mycobacterium tuberculosis. It is often associated with systemic symptoms and can mimic granulomatous orchitis.
  • Bacterial Epididymo-Orchitis: Another form of epididymo-orchitis caused by bacterial infections, which can also present similarly to granulomatous orchitis.
  • Spermatogenic Granulomas: A rare condition characterized by the formation of granulomas in the testes, often associated with inflammation and scarring.
  • Intratubular Germ-Cell Neoplasia: A type of cancer that affects the germ cells within the testes, which can present similarly to granulomatous orchitis.
  • Malignant Lymphomas: Certain types of lymphoma can affect the testes and mimic granulomatous orchitis.
  • Malakoplakia: A rare condition characterized by the formation of granulomas in the genitourinary tract, which can present similarly to granulomatous orchitis.

References:

  • [1] The major clinical differential diagnoses of granulomatous orchitis are testicular syphilis, testicular tumor, tuberculous epididymo-orchitis, bacterial epididymo-orchitis, spermatogenic granulomas, intratubular germ-cell neoplasia, malignant lymphomas, and malakoplakia.
  • [11] Differential diagnoses include non-neoplastic entities such as sarcoidosis, malakoplakia, sperm granuloma, and inflammatory etiologies including tuberculous epididymo-orchitis.
  • [14] An important differential diagnosis to consider for idiopathic granulomatous orchitis is IgG4-related disease.

Additional Differential Diagnoses

  • Testicular Syphilis
  • Testicular Tumor
  • Tuberculous Epididymo-Orchitis
  • Bacterial Epididymo-Orchitis
  • Spermatogenic Granulomas
  • Intratubular Germ-Cell Neoplasia
  • Malignant Lymphomas
  • Malakoplakia

Additional Information

rdf-schema#domain
https://w3id.org/def/predibionto#has_symptom_10125
oboInOwl#hasOBONamespace
disease_ontology
oboInOwl#id
DOID:3089
core#notation
DOID:3089
oboInOwl#hasDbXref
UMLS_CUI:C0436545
rdf-schema#label
granulomatous orchitis
oboInOwl#hasExactSynonym
Non-Specific Granulomatous Orchitis
oboInOwl#inSubset
http://purl.obolibrary.org/obo/doid#NCIthesaurus
rdf-schema#subClassOf
http://purl.obolibrary.org/obo/DOID_2519
22-rdf-syntax-ns#type
http://www.w3.org/2002/07/owl#Class

Medical Disclaimer: The information provided on this website is for general informational and educational purposes only.

It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with questions about your medical condition.