Testicular and Paratesticular Lesions Associated with Arteriosclerosis

This chapter brings together a variety of lesions that are secondary to arteriosclerosis. Some affect the testicle as in the case of atheromatous embolism or intracavitary polypoid nodular proliferation of the rete testis. Others affect paratesticular structures such as ischemic epididymitis and paratesticular hematoma. Intracavitary nodular polypoid calcifying proliferation of the rete testis and ischemic epididymitis are known from autopsy or from orchiectomy specimens with a different pathology and are asymptomatic. Atheromatous embolism may be asymptomatic, but it not infrequently leads to testicular infarcts, especially in patients who have undergone endovascular aneurysm repair. In most paratesticular hematomas, there is a surgical or medical history suggestive of the diagnosis, but a small group of testicular hematomas are idiopathic and can be clinically confused with epididymitis or paratesticular tumours so definitive diagnosis requires histological examination.