When tuberculosis of the testis was first accepted as a disease, caseation was taken as the diagnostic criterion and gross examinations alone sufficed. Such a standard for diagnosis, of course, did not separate tuberculosis from other caseous diseases. Later, when the histologic structure of tuberculous lesions was established, the microscopic examinations and the demonstration of acid-fast bacilli in characteristic tissue lesions became the standards of reference. In 1877, Gaule1 stated that there were two interpretations of the genesis and composition of testicular tuberculosis. The first was from Virchow, who noted the testicle tubercle always as a small gray translucent nodule similar in structure to the miliary tubercles of other viscera and the larger lesions as conglomerates of these smaller nodules; the other from Rindfleish, who described larger spherical caseous nodules which conglomerated into groups, became confluent and formed lesions with an irregularly nodular or branched configuration. According to Rindfleish,
HIRSCH EF. DIFFUSE INTRATUBULAR TUBERCULOSIS OF THE HUMAN TESTICLE. JAMA. 1933;100(15):1160–1162. doi:10.1001/jama.1933.02740150018007
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