最近経験した性器結核の3例

Three recent cases of tuberculous epididymitis

　症例は1例が72歳，2例が57歳の男性の3症例である。1例が左有痛性陰囊部腫瘤，2例が左無痛性陰囊部腫瘤を主訴とし，血液検査で，2例でCRPがやや高く，血沈は全例，亢進していた。AFP，HCG-βは正常であった。尿沈渣で1例に白血球多数を認めた。全例，肺結核の既往はない。3例とも精巣上体炎と診断され，1か月の抗生剤投与を受けたが，左陰囊の腫脹はひかず，精巣腫瘍を否定できないため，高位精巣摘除術を施行した。病理学検査で性器結核と診断された。

　We report three cases of tuberculous epididymitis.One patient was a 72-year-old man,and other two patients were 57-year-old.The chief complaint was painful swelling of the left scrotum in one patient and painless swelling of the left scrotum in the other two patients.Levels of C-reactive protein were elevated in two patients,and the erythrocyte sedimentation rate was elevated in all patients.Serum α－fetoproteins and human chorionic gonadotropin－βwere normal.One patient showed marked pyuria.No patients had a history of pulmonary tuberculosis.Ultrasonography showed a hypervascular intratesticular lesion with heterogeneous echogeneity in one patient and a lesion with relatively homogeneous echogeneity in another patient.Oral antibiotics was ineffective,with the size of left scrotal mass remained unchanged in all patients.High inguinal orchiectomy was performed in all patients,and the diagnosis of tuberculous epididymitis was obtained on the basis of bacteriologic and pathologic examinations of resected specimens.