Testicular Involvement in Noninfectious Vasculitis

Abstract

Testicular vasculitis is usually the manifestation of a systemic disease. Less frequent testicular vasculitis is the first symptom of a systemic disease. Exceptionally it is the only finding in a vasculitis similar to the systemic ones. All types of vasculitis can affect the testicle. The most common one is the involvement by polyarteritis nodosa. Testicular vasculitis is clinically present in different manners, simulating epididymitis, orchitis, testicular torsion, or tumor. In most cases the diagnosis is histological. As most vasculites cause testicular infarction, a systematic research for the typical lesions of vasculitis is important for a final diagnosis, especially in the segmental infarction. The most typical findings of testicular lesions in the following vasculites are described in this chapter: polyarteritis nodosa, Henoch-Schonlein purpura, Wegener’s granulomatosis, giant cell arteritis, thromboangiitis obliterans (TAO), Kogan’s disease, and Behcet’s disease. A special comment on isolated arteritis of the testis and epididymis (arteritis type PAN and Wegener granulomatous arteritis type) associated with testicular tumors is also offered.