Bilateral testicular tuberculomas: a case detection

Genitourinary tuberculosis (TB) is the most frequent manifestation of extrapulmonary TB, where the epididymides, seminal vesicles and prostate are the commonly infected sites, followed by the testes. We report a 29‐year‐old man who presented with primary infertility since 2 years. He had a history of bilateral painful scrotal swelling with fever since 4 years, diagnosed as pyogenic scrotal abscess, which was managed by incision and drainage. At presentation, fever, weight loss and night sweats were absent. On examination, he had ovoid slightly tender, firm to hard irregular masses in the lower poles of both testes with no line of separation encroaching on both epididymes. Both testes were not felt distinctly and the overlying scrotal skin showed no signs of inflammation. Semen analysis revealed azoospermia. Scrotal colour coded duplex ultrasonography demonstrated moderately enlarged testes having well defined hypoechoic masses with foci of calcifications. Magnetic resonance imaging confirmed these findings. Biopsy and histopathology detected the presence of caseating granuloma and Ziehl–Neelsen staining of paraffin sections demonstrated acid‐fast bacilli. The patient was treated with combination therapy. Tracing of the condition is discussed.     

Renal tuberculosis: a case report

Tuberculosis or TB (tubercle bacillus) remains a major public health problem in developing countries. Over the last decades extra-pulmonary locations of the disease have become more frequent due to the increased prevalence of acquired immune deficiency syndrome and the increase number of organ transplants. The urogenital localization represents about 27% of all extra-pulmonary localizations of TB and may be due either to a disseminated infection or to a primitive genitourinary localization. The majority of patients, has pyuria, sometimes with hematuria. The diagnosis of urinary tuberculosis is based on the finding of pyuria in the absence of infection by common bacteria. The initial medical treatment includes isoniazide, rifampicin, pyrazinami-de, ethambutol and streptomycin. This disease should be suspected in patients with unexplained urinary tract infections, especially if immunocompromised and/or coming from endemic areas.     

Isolated testicular tuberculosis: report of a case

In this study, a case has been reported involving a 66-year old male who was admitted for scrotal pain on the right side with possible testicular involvement, but with no associated urinary disorder. At physical examination, the right testicle was found to have increased in volume: this was further confirmed by ultrasonography, but the findings were insufficient to exclude the hypothesis of testicular cancer. An exploratory orchidectomy by upper inguinal route was therefore carried out, and histopathological examination showed the destruction of testicular tissue by several granulomas, and caseous necrosis with giant cells. Antibacterial chemotherapy was administered after an i.v. urography found no evidence of abnormality or urinary disorder, thereby eliminating an active site of genitourinary tuberculosis. This case shows the importance of considering testicular tuberculosis in the differential diagnosis of testicular enlargement in a region where this disease is endemic, despite the absence of systemic pulmonary and urinary signs of tuberculosis.     

Multifocal bone tuberculosis: A case report

Multifocal long bones tuberculosis without articular involvement is very rare. Pain and swelling are the common presenting symptoms. Difficulties in diagnosis often lead to delayed treatment, sometimes with devastating consequences for patients. Radiographs may mimic other diseases. Histopathological study is necessary to establish the diagnosis. The antibacillary chemotherapy produces excellent results. We report a case of a 60-year-old woman afflicted with multifocal tibial tuberculosis.     

睾丸横过异位的诊断和治疗：附1例报告并文献复习

目的探讨睾丸横过异位的诊断和治疗。方法患儿,7岁,男性,术前超声、CT判断右侧隐睾位于同侧腹腔内,腹腔镜下见患侧睾丸精索血管横过异位,双输精管单侧起源伴行,与对侧精索及横过睾丸精索血管共同穿过已闭合的内环口,进入对侧腹股沟管。腹腔镜下游离患侧精索,经腹股沟开放手术将异位睾丸通过阴囊中隔复位固定到对侧阴囊肉膜下。结果术中未发现苗勒管残留,手术顺利。术后随访3个月,患儿双侧睾丸位置理想,血流良好。结论睾丸横过异位是罕见睾丸下降不良畸形,术前难确诊,宜及早诊治,腹腔镜处理有优势。     

Isolated medial cuneiform tuberculosis: A case report

Skeletal involvement in extrapulmonary tuberculosis is extremely rare, and foot involvement accounts for less than 10% of osteoarticular tuberculosis. Tuberculosis osteomyelitis of the foot can also mimic a wide range of pathology. As a result, this condition is often misdiagnosed, or the true nature of the lesion is identified late in the diagnostic process. This article reports a case of tuberculosis in the medial cuneiform of a 3-year-old girl. Initially misdiagnosed as osteochondrosis, the patient returned 2 years later with a draining sinus on the medial aspect of the left midfoot. New radiographs showed a cystic lesion in the substance of the medial cuneiform. A diagnosis of tuberculosis was established after biopsy and histopathological examination of operative specimen. Antituberculosis treatment was implemented and continued for 16 months. At that time, clinical signs of infection had ceased.     

肠结核的诊断及外科治疗37例报告

目的探讨肠结核诊断及内、外科治疗方法。方法回顾性病例分析及文献综述。结果我院１９８３～１９９７年共收治３７例肠结核病例,其中２６例行钡餐阳性率１００％（２６／２６）、钡灌肠２４例阳性率１００％（２４／２４）和纤维结肠镜１７例阳性率９４１％（１６／１７）。单纯内科治疗２１例,１６例因并发症或误诊接受外科治疗,１３例切除病变肠管,３例行开腹活检或穿孔修补术。内科治疗组,抗结核时间２０个月,复发４例;切除病变肠管的１３例患者平均抗结核时间１０个月,没有复发;行开腹活检或穿孔修补的３例患者抗结核时间１９个月,１例复发。结论钡餐、钡灌肠、纤维结肠镜是较为有效的检查方法,对于伴有腹部并发症的患者及早积极采用外科手术治疗切除病变肠管及术后抗结核治疗,从治疗时间、治疗复发等方面可能优于单纯内科保守治疗。     

Isolated tuberculosis of the spleen: A case report and review of literature

Isolated involvement of spleen in tuberculosis is a rare entity, particularly among immunocompetent hosts. Herein, we present a 28-year-old man with left abdominal discomfort for 2 years who was found to have a cystic lesion in spleen on evaluation. Eventually, he was diagnosed to have isolated splenic tuberculosis with an involvement of a single lymph node at the splenic hilum. In this rare form of tuberculosis, it seems that splenectomy in addition to standard antitubercular therapy is curative.     

A case of testicular angiomyolipoma

Abstract:   The majority of testicular tumors are germ cell tumors, which are the most prevalent solid malignancies in young adult males. Non-germ cell tumors of the testis are rare. Here, we report a case of testicular angiomyolipoma (AML). A 22-year-old male underwent left orchiectomy under a diagnosis of testicular tumor. Pathological analysis demonstrated that it was composed of adipose tissue and vasculature with foci of myomatous component. The tumor demonstrated neither cytological atypia nor widespread mitotic activity. In addition, the tumor cells showed intense expression of CD34 and smooth muscle actin, whereas HMB-45 was entirely negative. Although the true cellular origin and its clinical implications remain unknown, pathological and immunohistochemical studies strongly indicated benign testicular AML with a non-germ cell origin. To our knowledge, this is only the second case of a primary testicular AML in the published reports and the detailed pathological findings are first described in this report.     

肾上腺结核的诊断与治疗(附4例报道及文献复习)

目的 提高对肾上腺结核诊断与治疗的认识。方法 回顾本院4例肾上腺结核病例的诊断与治疗结合文献复习。4例病例均予生化、B超和CT检查及抗结核、长期激素替代治疗或手术处理。结果 抗结核、长期激素替代治疗或手术处理使肾上腺结核引起的Addison's病得到满意的疗效。结论 根据临床特征,结合生化和肾上腺影像学检查或手术切除病理检查确定肾上腺结核诊断。抗结核、长期激素替代或手术是治疗肾上腺结核的主要方法。     

Polyorchidism: a case report and classification

Polyorchidism is an uncommon congenital anomaly, defined as the presence of more than 2—histologically proven—testes. Approximately 90 cases are reported in the literature. It is found predominantly on the left side. We report a right-sided polyorchidism found during orchidopexy in a 6-year-old boy. The supernumerary testis had its own tunica vaginalis, epididymis, and deferent duct, but shared the blood supply with the ipsilateral distal testis. The diagnosis was confirmed histologically. Because of the shortness of its vessels, the supernumerary testis could not undergo orchidopexy and was removed.We review the classification systems proposed for polyorchidism. Most are based on embryologic considerations, but none is capable of including all cases described in the literature. Thus, we present an anatomical system for a more comprehensive taxonomy of polyorchidism according to its reproductive function.     

Preperitoneal ectopic testis: a case report

We report a 5 1/2-year-old boy with preperitoneal ectopic testes. This condition has been reported only once before. Both testes were attached to the umbilicus and at operation were successfully placed in the scrotum.     

Polyorchidism: a case report and review of the literature

Polyorchidism is defined as the presence of two or more testes. It is a rare anomaly with approximately 77 cases reported in the literature. Polyorchidism is frequently associated with additional urological pathologies such as undescended testis, inguinal hernia, testicular torsion, hydrocoele, malignancy and infertility. Differential diagnosis includes spermatocoele, hydrocoele, epididymal cysts or aberrant epididymis. We report on an interesting case of polyorchidism in a 15-year-old man diagnosed on ultrasound and we review the literature and current management of polyorchidism.     

临床肾结核32年回顾（附349例分析）

回顾分析了３４９例肾结核的临床资料，发现近年来肾结核不典型病例显著增加，从而造成明显的延误诊断现象。肾结核早期诊断中，尿ＰＣＲＴＢＤＮＡ检查阳性率高，可作为常规措施推广使用。Ｂ超在肾结核的诊断中特异性差，仅为初选病人的筛选手段，确诊时需强调ＩＶＵ的特征性改变。随着抗痨药物的不断发展，药物治疗肾结核的适应证有扩大趋势     

泌尿系结核的诊断体会（附36例报告）

目的：提高泌尿系结核的诊断水平,方法：回顾性分析36例泌尿系结核的临床资料,总结其诊断经验,结果：最常见的主诉为尿路刺激征和血尿,分别为64％和47％;尿沉渣涂片找抗酸杆菌和尿PCR－TBDN阳性率分别为22％和30％,IVU,逆行肾盂造影,CT的确诊率分别为33％,29％和68％,36例接受手术治疗,且术后病理检查均证实为泌尿系结核。结论：泌尿系结核的临床诊断应综合病史,尿液分析,影像学检查,病原学诊断等多种方法,力求寻找更多证据,X线检查应首选IVU和逆行肾盂造影,对两者未能明确诊断者,可选择CT检查,对于中,晚期肾结核,CT的诊断价值较逆行肾盂造影更大。     

Traumatic testicular torsion: case report

Trauma has been reported as an infrequent cause of testicular torsion. A case of trauma-induced testicular torsion is reported and literature reviewed. The inclusion of torsion in the differential diagnosis of post-traumatic acute scrotal pain is important to ensure early appropriate management.     

肾结核的早期诊断与治疗

目的 探讨肾结核的早期诊断和治疗方法.方法 回顾性分析96例早期肾结核患者的临床资料.男58例,女38例.年龄17～52岁,平均34岁.病程2～22个月,平均10个月.右侧42例,左侧54例.合并附睾结核12例,肺结核28例.96例均行常规实验室及影像学检查.均行药物治疗,无效者行肾切除.结果本组血尿、尿频、尿急、尿痛和腰痛是肾结核最常见的症状,分别占67.7%(65/96)、54.2%(52/96)、43.7%(42/96)、37.5%(36/96)和22.9%(22/96).KUB+IVU、B超、CT、膀胱黏膜活检诊断符合率分别为67.7%、12.5%、37.5%、33.3%.96例采用抗结核药物[异烟肼(INH)+利福平(RFP)+乙胺丁醇(EMB)或吡嗪酰胺(PIA)]治疗6～8个月,临床治愈38例(39.1%),好转43例(44.8%).15例药物治疗无效者改行肾切除.结论尿液检查、IVU、膀胱镜检查及黏膜活检对肾结核早期诊断有十分重要的意义.INH+RFP+EMB或PIA三联治疗早期肾结核效果满意.     

Polyorchidism with varicocele: a case report and review of literature

Polyorchidism is defined as the presence of more than 2 histologically proven testes. We report the case of a 20-year-old man with polyorchidism, presenting with right scrotal pain and right scrotal ovoid mass. Scrotal examination revealed two ovoid, mobile lumps with testicular sensation in the right side of the scrotum. Scrotal colour Doppler ultrasonography and magnetic resonance imaging confirmed the presence of double testes with common epididymis and common vas. Microscopic varicocele ligation was performed, and then, two ipsilateral testes were sutured together. The testes were then returned to the scrotum with fixation.