REPRODUCTIVE ORGANS OF THE MALE. 719 



Tuberculous Orchitis may occur in connection with tuberculosis of the 

 other genito- urinary organs or the lungs, in acute general miliary tuber- 

 culosis, or independently. It usually originates in the epididymis, and 

 may extend from there to the testis ; or it may commence in the testis. 

 The appearances which the testicles present, when they are the seat of 

 this form of inflammation, are exceedingly varied and often difficult of 

 interpretation. This is partly due to the complex structure of the organ, 

 partly to the varied complicating simple inflammatory changes which 

 the different parts of the organ undergo in connection with the tuber- 

 culous lesion. 



We may find in the testicle small circumscribed masses of cells, visi- 

 ble to the naked eye as whitish spots, which are sometimes composed of 

 small spheroidal cells or of larger polyhedral or fusiform or round cells. 

 These occur in the walls of seminiferous tubules and blood-vessels, and 



FIG. 473. TUBERCULOUS ORCHITIS. 



in the interstitial tissue. Sometimes associated with these smaller nod- 

 ules, and sometimes not, we find larger, irregular yellowish or gray 

 cheesy masses, which may be formed by the confluence and degeneration 

 of the smaller nodules (Fig. 473). The cheesy masses may break down 

 and open externally, giving rise to fistulse, gangrenous inflammation, etc. 

 Hand-in-haud with this distinctly tuberculous nodular formation of 

 tissue, which is disposed to degenerative changes, there are various more 

 or less diffuse alterations of the parenchyma and interstitial tissue of 

 the organ which often constitute a most prominent feature of the lesion. 

 The interstitial tissue may be more or less densely and diffusely in- 

 filtrated with small spheroidal cells. The arteries are often the seat of 

 obliterating endarteritis. The walls of the seminiferous tubules may be 

 very much thickened, so that the lumen may be entirely obliterated. 



