PDF(Pubmed)
Abstract：
A 31-year-old man with left-sided testicular pain lasting a couple of months was referred to our urology department due to a suspected testicular tumor. Physical examination showed a hard, thickened, and small left testis on palpation with a diffuse, inhomogeneous ultrasonographic appearance. After a urologic examination, a left-sided inguinal orchiectomy was performed. The testis, epididymis, and spermatic cord were sent to pathology. Gross examination revealed a cystic cavity filled with brown fluid and the surrounding brownish parenchyma measuring up to 3.5 cm in diameter. Histologic examination showed a cystically dilated rete testis lined with cuboidal epithelium and a positive immunohistochemical reaction to cytokeratins. Microscopically, the cystic cavity was a pseudocyst filled with extravasated erythrocytes and abundant clusters of siderophages. The siderophages extended into the testicular parenchyma, surrounding the seminiferous tubules and spreading out around the ducts of the epididymis, which were also cystically dilated with siderophages inside their lumina. On the basis of clinical data, histological, and immunohistochemical analysis, the patient was diagnosed with cystic dysplasia of the rete testis. The literature shows an association between cystic dysplasia of the rete testis and ipsilateral genitourinary anomalies. Therefore, our patient underwent a multi-slice computed tomography scan, which revealed ipsilateral renal agenesis, a right seminal vesicle cyst reaching up to the iliac arteries, and a multicystic formation cranial to the prostate.
摘要：
一名31岁的男性左侧睾丸疼痛持续了几个月，由于疑似睾丸肿瘤，他被转诊到我们的泌尿科。体检显示，加厚，触诊时左睾丸小，弥漫性，不均匀的超声检查外观。泌尿科检查后,进行了左侧腹股沟睾丸切除术.睾丸,附睾,精索被送去病理。大体检查发现囊腔充满棕色液体，周围的褐色薄壁组织直径达3.5厘米。组织学检查显示，膀胱扩张的网状睾丸内衬立方体上皮，对细胞角蛋白的免疫组织化学反应阳性。微观上,囊腔是一个假性囊肿，充满外渗的红细胞和大量的铁皮噬菌体簇。铁皮噬菌体延伸到睾丸实质，围绕着生精小管，并在附睾导管周围扩散，它们的内腔里也有铁皮噬菌体。根据临床数据，组织学,和免疫组织化学分析，患者被诊断为睾丸网状囊性发育不良。文献显示，睾丸网的囊性发育不良与同侧泌尿生殖系统异常之间存在关联。因此,我们的病人接受了多层计算机断层扫描,揭示了同侧肾发育不全，右精囊囊肿一直延伸到髂动脉,和前列腺颅部的多囊性形成。
