Abstract
Genitourinary tuberculosis is the second most common extrapulmonary tuberculosis (ETB), after lymph nodes. Isolated tuberculous epididymitis (ITE) is a rare entity among genitourinary tuberculosis and is defined as epididymitis without clinical evidence of either renal or prostate involvement. We present a case of epididymal tuberculosis in a 26 year old male which presented as a right scrotal mass. We discussed this case to emphasize that tuberculous etiology should also be considered in the differential diagnosis of scrotal mass besides malignancy, and an image guided fine needle aspiration cytology (FNAC) and stain for acid fast bacilli (AFB) play crucial role in diagnosis and treatment.
 IMC J Med Sci 2019; 13(1): 003
Highlights
Cases ReportGenitourinary tuberculosis (GUTB) contributes to 30% of extrapulmonary tuberculosis and is a major health problem in India
Isolated tuberculous epididymitis (ITE), if diagnosed correctly, can potentially be cured by anti-TB medications, and surgical resection is usually reserved for those patients who do not respond to medical treatment [4]
We present a case of isolated epididymal tuberculosis, which presented as a right scrotal mass in a 26 year old male
Summary
Genitourinary tuberculosis (GUTB) contributes to 30% of extrapulmonary tuberculosis and is a major health problem in India. Isolated tuberculous epididymitis (ITE) without evidence of renal involvement is, rare and difficult to diagnose. We present a case of isolated epididymal tuberculosis, which presented as a right scrotal mass in a 26 year old male. Scrotal ultrasonography (USG) showed enlarged Ultrasound guided FNAC was performed with epididymis with marked heterogenous ecotexture. Enlarged epididymis (blue arrow) with ultrasound guided needle within (red arrow); 1b. Cytolological examination of aspirated material by hematoxylin and eosin (H&E) and Pap stains revealed caseous necrotic material, nuclear debris, histiocytes and few granulomas consisting of epithelioid cells (Fig-2A, B & C). Ziehl-Neelson (ZN) stain showed many acid fast bacilli (Fig-2D). It was diagnosed as a case of tuberculous epididymitis.
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