Spermatic granuloma. Diagnosis by fine needle aspiration cytology

Spermatic granulomas may present as tumorlike lesions adjacent to the testis or seminal vesicle and are often associated with infection, trauma or previous surgery. The fine needle aspiration biopsy cytologic findings in three cases of spermatic granuloma are reported. The predominant cytologic features were granulomatous inflammation (nontuberculous and non-foreign body) and spermatozoids (intrahistiocytic or as extracellular spermatic debris). Additional features included lymphoid cells and lymphocytic debris (nuclear tangles), rare plasma cells and eosinophils. Germ cells and acellular (caseous) necrosis were not identified. Well-preserved sheets of epididymal epithelium were occasionally noted. The clinical and cytologic differential diagnoses in such cases are discussed.