Histopathological Scenario of Testicular Lesions with Few Uncommon Entities – 3 Years Study in a Tertiary Care Hospital

BACKGROUND The incidence of testicular malignancy has been increasing in men, orchidectomy is necessary for the removal of neoplastic lesions or in patients with chronic inflammatory conditions resistant to treatment. We wanted to evaluate the various histopathological patterns of lesions in testis. METHODS A retrospective study of 86 orchidectomy specimens over a period of three years with age wise distribution from March 2017 to February 2020 was done in the Department of Pathology, Guntur Medical College, Guntur. Histopathological slides stained with haematoxylin and eosin were retrieved and reviewed. Immunohistochemistry was done in two cases. RESULTS Of the 86 cases, 78 (90.7 %) cases were non neoplastic and 8 (9.3 %) cases were neoplastic. Youngest age in non-neoplastic group was four days and in neoplastic group was 18 years. The oldest age was 82 years in the non-neoplastic lesions and 60 years in the neoplastic lesions. Non neoplastic lesions were common in the 3 rd decade. In malignant lesions, highest number of cases was seen in the 6 th decade and equal distribution was observed in 3rd and 5th decade. Unilateral involvement was common than bilateral involvement. Out of all non-neoplastic lesions, undescended testis 20 (25.64 %) cases was the common finding followed by non-specific epididymo orchitis 19 (24.36 %) cases, abscess 14 (17.95 %) cases, torsion infarction 13 (16.67 %) cases, Leydig cell hyperplasia 4 (5.13 %) cases, 3 (3.85 %) cases each of tuberculous epididymo orchitis and granulomatous epididymo orchitis. 1 (1.28 %) case each of rare entities like vanishing testis and splenogonadal fusion were also found. Among the neoplastic lesions, all 8 cases were malignant tumours. Out of these malignant tumours, mixed germ cell tumours were seen in 3 (37.5 %) cases followed by seminomas 2 (25 %) cases, post pubertal teratoma 1 (12.5 %) case, non-Hodgkin’s lymphoma (NHL) 1 (12.5 %) case and primitive neuroectodermal tumour (PNET) 1 (12.5 %) case. CONCLUSIONS Histopathological examination on routine haematoxylin and eosin (H&E) stained sections primarily differentiate non neoplastic lesions from neoplastic group and benign tumours from malignant tumours as the treatment modality varies. Immunohistochemistry (IHC) is useful in the diagnosis of poorly differentiated small round cell tumours. KEYWORDS Orchidectomy Specimens, Neoplastic and Non-Neoplastic Lesions