Testicular lesions of periarteritis nodosa,with special reference to diagnosis

Significant morbid changes were found at necropsy in the testes of forty-one of forty-four male patients with periarteritis nodosa. Abnormalities included specific lesions in the arteries, recent and healed infarcts, diffuse parenchymal obliteration, focal degeneration of testicular tubules, hematomas and hemorrhage. The testes in a fourth of the patients were obviously smaller than normal. Testicular arterial lesions diagnostic of periarteritis nodosa were found in thirty-eight of the forty-four patients (86 per cent).Symptomatic or objective abnormalities of the testes were noted clinically in eight of the forty-four patients. The rarity of symptoms and signs of testicular abnormalities in other generalized diseases suggests that careful search for testicular pain, tenderness or swelling, or a decrease in size of one or both testes in the presence of evidence of vascular disease in other organ systems may aid in establishing the diagnosis clinically.It is estimated that the diagnosis of periarteritis nodosa can be made by testicular biopsy in one-fifth of male patients who have that disease. Biopsy of a testis may be considered when a clinical testicular abnormality is apparent in a patient suspected of having periarteritis nodosa who does not present any cutaneous, subcutaneous or muscular lesions. Biopsy should include a portion of the tunica vasculosa and of the underlying parenchyma.