title: Testicular vasculitis: a series of 19 cases.
abstract: OBJECTIVE
  Because of limited reported cases, it is unknown how often testicular vasculitis represents isolated or systemic disease.
  
  
  METHODS
  We report 19 cases (15 consultation; 4 in-house cases) of localized testicular infarction with associated vasculitis spanning 24 years.
  
  
  RESULTS
  All were orchiectomy specimens; detailed clinical information was available in 16 cases. Mean age was 38 years. Clinical presentation was testicular pain in 13 and mass in 3 patients. Preoperative impression was testicular cancer in 13 cases. In all cases, localized testicular infarction associated with vasculitis was present and in none was tumor identified. Most cases (n = 14) showed polyarteritis nodosa (PAN)-like features with transmural necrotizing inflammation of small-medium arteries. In 4 cases, vasculitis was granulomatous (2 necrotizing; 2 non-necrotizing) and in 1 case was lymphocytic. An infectious etiology was excluded clinically and by special stains. Four patients were subsequently confirmed with systemic vasculitis: one with PAN, one with Wegener vasculitis, one with vasculitis not otherwise specified and one with subclinical systemic vasculitis. Two of those 4 patients had testicular PAN-like vasculitis and 2 had granulomatous vasculitis.
  
  
  CONCLUSIONS
  Testicular vasculitis can cause localized infarction that clinically mimics cancer. Although testicular vasculitis is an isolated finding in most patients an associated systemic vasculitis is not a rare event (4/16, or 25%), especially if the vasculitis is granulomatous (50% in this series). All patients should be clinically investigated for systemic disease.
authors.affiliation: Department of Pathology, McGill University Health Center, Montreal, Canada.
authors.forename: Fadi
authors.initials: F
authors.lastname: Brimo
authors.forename: Jonathan
authors.initials: J
authors.lastname: Lachapelle
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Epstein
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D007238:Infarction / Q000150:complications; D008297:Male; D008875:Middle Aged; D013737:Testis / Q000098:blood supply*; D014657:Vasculitis / Q000175:diagnosis* / Q000209:etiology; D055815:Young Adult