Orchitis: An unusual presentation of polyarteritis nodosa

• Main Authors: Nelofar Islam, Debanjali Sinha, Parasar Ghosh, Chhanda Datta, Uttara Chatterjee
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2018-01-01
• Series: Indian Journal of Pathology and Microbiology
• Subjects: Epididymo-orchitis; polyarteritis nodosa; vasculitis
• Online Access: http://www.ijpmonline.org/article.asp?issn=0377-4929;year=2018;volume=61;issue=4;spage=600;epage=603;aulast=Islam

Polyarteritis nodosa (PAN), a systemic necrotizing vasculitis with multiorgan development, is generally restricted to the medium-sized muscular arteries. The varied initial clinical presentations of PAN can lead to a delayed diagnosis. We present the case of a middle-aged male patient who presented with an acute onset right-sided testicular pain as the initial clinical symptom with ischemic changes on ultrasonogram, thereby requiring orchiectomy. This was reported to be a case of tubercular epididymo-orchitis. On review, the biopsy revealed features of necrotizing arteritis as seen in PAN with fibrinoid necrosis and giant cells, thus highlighting the fact that vasculitis due to PAN may have a localized presentation at the time of diagnosis. PAN should be distinguished from other causes of epididymo-orchitis and other vasculitis lesions, the most common being tubercular etiology in the Asian population.