Testis & epididymis

Nonneoplastic lesions

Fibrous pseudotumor



Topic Completed: 1 March 2015

Minor changes: 8 August 2021

Copyright: 2003-2021, PathologyOutlines.com, Inc.

PubMed search: Fibrous pseudotumor testis

Swapnil U. Rane, M.D.
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Cite this page: Rane S. Fibrous pseudotumor. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/testisepidfibrpseudotumor.html. Accessed December 3rd, 2021.
Definition / general
  • Diffuse or localized, reactive fibromatous proliferation involving epididymis, tunica or spermatic cord
  • May simulate a testicular tumor (Arch Surg 1978;113:814)
  • May cause bowel wall perforation in infants with meconium periorchitis
Terminology
  • Other terms used:
    • Fibroma
    • Nonspecific peritesticular fibrosis
    • Nodular fibrous periorchitis, chronic proliferative periorchitis, reactive periorchitis or pseudofibrous periorchitis
    • Fibrous periorchitis (for diffuse lesions)
    • Proliferative funiculitis
    • Nodular pseudotumor (if forms a mass)
    • Inflammatory fibropseudotumor or pseudotumor (if forms a mass)
    • Peritesticular fibromatosis
    • Fibrous mesothelioma
Sites
  • Typically involves tunica albuginea
Case reports
Radiology images

Images hosted on other servers:

MRI: polycyclic mass

Clinical images

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Intrascrotal mass

Gross description
  • Can show diffuse band-like thickening, often encasing the testis
  • Localized forms show single or multiple nodules, 2 mm to 9 cm
  • Cut surface is usually firm, whitish
Gross images

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Pedunculated mass

Well demarcated margins

Microscopic (histologic) description
  • Dense fibrosis, focal edema, lymphangiectasis and perivascular round cell infiltration
  • Active epididymitis and chronic interstitial orchitis present in some cases
  • Associated with fibrinous or hyalinized loose bodies in cavity
  • Composed primarily of spindle cells with variable hyalinization and collagenization
  • Variable component of lymphocytes, plasma cells, histiocytes and scattered eosinophils
  • Nuclear atypia is usually absent, and if present is usually focal and restricted to the more cellular areas with more florid granulation tissue-like proliferation
  • May have focal whorled arrangement, focal calcification and ossification
  • Usually no mitoses
  • No atypical mitoses
Microscopic (histologic) images

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Dense fibrotic tissue

Collagen rich hyalinized fibrotic tissue

CD3

IgG4

CD31

Differential diagnosis
  • Sarcomas: generally are more cellular, with atypical mitoses and pleomorphism
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