Examination of the removed testicle and its appendix in inflammatory diseases (PG052)

Pathomorphological examination of the removed organ complex (orchio-epididymectomy) — is a comprehensive analysis of the testicle, its appendix and a fragment of the spermatic cord, removed due to irreversible inflammatory processes. Code PG052 is used in cases where conservative treatment has not yielded results, and the inflammation has led to tissue destruction (destruction) or the threat of spreading infection (sepsis).

Research objective: The main task is to establish the exact cause and nature of the inflammation. The study allows you to distinguish banal purulent inflammation from specific infections (tuberculosis, syphilis) or autoimmune processes. In addition, histological analysis is mandatory to exclude a "masked" tumor, which could be the root cause of secondary inflammation.

What does the pathologist evaluate:

• Degree of parenchymal destruction: assessment of the prevalence of necrosis (tissue death) and abscessation (pus formation) in the testicle and appendix.

• Etiology of inflammation: looking for specific signs (e.g., granulomas in tuberculosis or sarcoidosis).

• Condition of blood vessels: detection of signs of vasculitis or thrombosis of the spermatic cord vessels, which could have caused testicular infarction.

• Presence of fibrosis and atrophy: assessment of the replacement of functional tissue with scar tissue, which explains the loss of organ function.

• Exclusion of neoplasia: a thorough search for cancer cells that could have triggered reactive inflammation around the tumor focus.

Clinical significance: The conclusion with the code PG052 is of critical importance for the further treatment of the patient. If a specific pathogen is detected (for example, mycobacterium tuberculosis), the patient requires long-term specific therapy. If the cause is an ischemic process or non-specific flora, the focus shifts to rehabilitation and monitoring of the condition of the second testicle to preserve reproductive and hormonal functions.

When is it prescribed:

• after removal of the testicle due to abscessing orchoepididymitis;

• purulent melting of the testicle (pyocele) with transition to the parenchyma;

• suspected tuberculosis of the male genital organs with the formation of fistulas;

• testicular necrosis due to advanced torsion or injury;

• removal of the "degenerate" testicle (long-term chronic inflammation with complete loss of function).