Granulomatous orchitis may be secondary to infection, trauma, autoimmune diseases, or extravasation of sperm. Some of the specific causative agents include tuberculosis, syphilis, leprosy, and brucellosis. In many cases, the cause remains unknown (idiopathic). In idiopathic (nonspecific) granulomatous orchitis, distinct granulomas are not present; however, the accumulation of epithelioid histiocytes, lymphocytes, and plasma cells in the seminiferous tubules creates an appearance of granulomas as seen here. In early stages, there may be scattered residual germ cells and Sertoli cells; however, in late stages, there is complete destruction of tubular architecture and atrophy with fibrosis.