Difference between revisions of "Testicular torsion"
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'''Testicular torsion''' is rotation of the [[testis]] resulting in reduced | '''Testicular torsion''' is rotation of the [[testis]] resulting in a reduced or absent blood flow with subsequent ischemia. | ||
==General== | ==General== | ||
| Line 9: | Line 9: | ||
Treatment: | Treatment: | ||
*Surgery. | *Surgery. | ||
==Gross== | |||
*Brown/black or red - due to necrosis/hemorrhage. | |||
Image: | |||
*[http://library.med.utah.edu/WebPath/MALEHTML/MALE083.html Testicular torsion (med.utah.edu)]. | |||
==Microscopic== | ==Microscopic== | ||
| Line 16: | Line 22: | ||
*+/-Necrosis of germ cells. | *+/-Necrosis of germ cells. | ||
DDx: | |||
* | *Testicular tumour (e.g. [[germ cell tumour]]).<ref name=pmid24061519>{{Cite journal | last1 = Kao | first1 = CS. | last2 = Zhang | first2 = C. | last3 = Ulbright | first3 = TM. | title = Testicular hemorrhage, necrosis, and vasculopathy: likely manifestations of intermittent torsion that clinically mimic a neoplasm. | journal = Am J Surg Pathol | volume = 38 | issue = 1 | pages = 34-44 | month = Jan | year = 2014 | doi = 10.1097/PAS.0b013e31829c0206 | PMID = 24061519 }}</ref> | ||
*[[Germ cell neoplasia in situ]] (incidental finding). | |||
===Grading=== | |||
Adapted from ''Mikuz'':<ref name=pmid3842075>{{Cite journal | last1 = Mikuz | first1 = G. | title = Testicular torsion: simple grading for histological evaluation of tissue damage. | journal = Appl Pathol | volume = 3 | issue = 3 | pages = 134-9 | month = | year = 1985 | doi = | PMID = 3842075 }}</ref> | |||
</ref> | {| class="wikitable center" | ||
! Grade | |||
! Features | |||
|- | |||
| 1 | |||
| intertubular edema, limited blood extravasation, desquamation of germ cells | |||
|- | |||
| 2 | |||
| diffuse intertubular hemorrhage, focal necrosis of the germ cells | |||
|- | |||
| 3 | |||
| diffuse infarction of parenchyma | |||
|} | |||
==Sign out== | |||
<pre> | |||
Right Testicle, Orchiectomy: | |||
- Testis with diffuse intratubular hemorrhage and focal desquamation | |||
of germ cells. | |||
- Epididymis with intratubular necrotic debris. | |||
- Changes compatible with testicular torsion. | |||
- NEGATIVE for germ cell neoplasia in situ (intratubular germ cell neoplasia). | |||
- NEGATIVE for malignancy. | |||
</pre> | |||
==See also== | ==See also== | ||
*[[Testis]]. | *[[Testis]]. | ||
*[[Testicular abscess]]. | |||
*[[Testicular trauma]]. | |||
*[[Infarction]]. | |||
*[[Ovarian infarct]]. | |||
*[[Ovarian torsion]]. | |||
==References== | ==References== | ||
Latest revision as of 19:27, 9 September 2021
Testicular torsion is rotation of the testis resulting in a reduced or absent blood flow with subsequent ischemia.
General
Clinical:
- Pain.
Treatment:
- Surgery.
Gross
- Brown/black or red - due to necrosis/hemorrhage.
Image:
Microscopic
Features:
- Intratubular hemorrhage.
- Desquamation of germ cells.
- +/-Necrosis of germ cells.
DDx:
- Testicular tumour (e.g. germ cell tumour).[1]
- Germ cell neoplasia in situ (incidental finding).
Grading
Adapted from Mikuz:[2]
| Grade | Features |
|---|---|
| 1 | intertubular edema, limited blood extravasation, desquamation of germ cells |
| 2 | diffuse intertubular hemorrhage, focal necrosis of the germ cells |
| 3 | diffuse infarction of parenchyma |
Sign out
Right Testicle, Orchiectomy: - Testis with diffuse intratubular hemorrhage and focal desquamation of germ cells. - Epididymis with intratubular necrotic debris. - Changes compatible with testicular torsion. - NEGATIVE for germ cell neoplasia in situ (intratubular germ cell neoplasia). - NEGATIVE for malignancy.
See also
References
- ↑ Kao, CS.; Zhang, C.; Ulbright, TM. (Jan 2014). "Testicular hemorrhage, necrosis, and vasculopathy: likely manifestations of intermittent torsion that clinically mimic a neoplasm.". Am J Surg Pathol 38 (1): 34-44. doi:10.1097/PAS.0b013e31829c0206. PMID 24061519.
- ↑ Mikuz, G. (1985). "Testicular torsion: simple grading for histological evaluation of tissue damage.". Appl Pathol 3 (3): 134-9. PMID 3842075.