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In idiopathic 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. 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.