This occurs in two forms, namely, as a late manifestation of the secondary stage or as a tertiary lesion. In the former case there is a generalized inflammation leading to induration like a chronic orchitis. The albuginea is thickened and the trabecule are enlarged as they converge towards the mediastinum. In the tertiary form there is more abundant granulation tissue along with gummata. The gummata may undergo caseous necrosis, and by coalescence of neighbouring tumours we may have considerable masses of caseous material. In the midst of this caseous material the outlines of the seminal tubes can sometimes be made out, indicating that the necrosis has overtaken the proper tissue as well as the new-formed.