In some cases of acute epididymitis, the infection may linger and become chronic. The epididymis shows marked chronic inflammation and fibrosis with induration, scarring, and distortion of the tubules. The image shows cystically dilated tubules containing spermatozoa and a chronic inflammatory infiltrate in the stroma. The lining epithelium is flattened. In late stages, one may see calcification, foreign body giant cell reaction and metaplastic changes.