The chance finding of two cases of undiagnosed malakoplakia in the files of the Department of Pathology, Queen's University Belfast prompted a systematic study of all cases of inflammatory testicular and epididymal disease diagnosed in that department during a 43-year period from 1934 to 1977. A total of 71 cases was studied, and no additional example of malakoplakia was found. In the Belfast collection, there is one other example of testicular malakoplakia and therefore a total of three cases in 74 examples of inflammatory testicular and epididymal disease (4.3% incidence). In the series there were 10 cases of granulomatous disease (13.5%). The world literature on testicular malakoplakia has been reviewed, and typical and atypical features have been determined. Also a comparison has been made between testicular malakoplakia and granulomatous orchitis, and the relationship between these conditions is discussed.
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