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INTRODUCTION: Genital tuberculosis (TB) is an uncommon form of extrapulmonary TB and testicular involvement only accounts for 3% of it. Due to its rarity, testicular TB is often mistaken for other pathologies such as malignancy, and the diagnosis of TB is delayed as we describe in our case report. CASE PRESENTATION:A 79-year-old Guatemalan male with heart failure and coronary artery disease presented with two weeks of left-sided chest pain and dyspnea along with unintentional weight loss and night sweat. Physical exam was notable for diffuse crackles. Chest radiograph found increased bilateral reticulonodular opacities compared to imaging taken five months ago. Computed tomography of the chest showed diffuse tree-in-bud and patchy nodular opacities with mediastinal lymphadenopathy and scattered calcified granulomas. Further history revealed that the patient had a painless testicular mass, which evolved to an abscess requiring treatment with levofloxacin two times. A subsequent orchiectomy was performed, which revealed necrotizing and non-necrotizing granulomas on pathology. Cultures were not sent but acid-fast bacilli (AFB) stain was negative. During the current admission, early morning induced sputum was obtained, and it was positive for AFB stain. The patient was started on anti-TB drugs adjusted to his co-morbidities and discharged after improved symptoms. Sputum culture later grew Mycobacterium tuberculosis (MTB), sensitive to the prescribed agents. DISCUSSION: Our case details a patient with pulmonary TB that first presented as granulomatous orchitis most likely due to MTB. Testicular TB presents with a painful or painless scrotal mass. As other common conditions like malignancy and orchitis are considered first, the diagnosis of TB gets delayed. Testicular cancer was the initial concern in this patient as well since he reported a painless scrotal mass with unintentional weight loss. When he later presented with abscess twice, he was empirically treated with levofloxacin. He also reported chest pressure at that time, which likely improved due to partial treatment with antibiotics. Post-orchiectomy pathology was AFB stain negative, but the findings of necrotizing and non-necrotizing granulomas are highly suspicious for TB. The patient's persistent respiratory complaints along with worsening radiographic findings finally led to the diagnosis of pulmonary TB. CONCLUSIONS:Clinicians must maintain a high index of suspicion for extrapulmonary TB in high-risk individuals as it often presents indolently and without classic systemic symptoms. In those with chronic orchitis, there should be a high suspicion for testicular TB. Should a biopsy be sent, AFB stain and culture need to be ordered. Furthermore, a workup for pulmonary TB should be initiated for appropriate treatment and follow-up.

Novel techniques to expose substrate-level defects are presented in this paper. New techniques such as inter-layer dielectric (ILD) thinning, high keV imaging, and XeF2 poly etch overflow are introduced. We describe these techniques as applied to two different defects types at FEOL. In the first case, by using ILD thinning and high keV imaging, coupled with focused ion beam (FIB) cross section and scanning transmission electron microscopy (STEM,) we were able to judge where to sample for TEM from a top down perspective while simultaneously providing the top down images giving both perspectives on the same sample. In the second case we show retention of the poly Si short after removal of CoSi2 formation on poly. Removal of the CoSi2 exposes the poly Si such that we can utilize XeF2 to remove poly without damaging gate oxide to reveal pinhole defects in the gate oxide. Overall, using these techniques have led to 1) increased chances of successfully finding the defects, 2) better characterization of the defects by having a planar view perspective and 3) reduced time in localizing defects compared to performing cross section alone.

An ARC solution that can be used to improve backside imaging for backside photoemission microscopy applications is presented in this paper. Zinc Oxide (ZnO) -based thin films used as ARCs are deposited at the backside of the failing units through a simple and low cost spray pyrolysis technique. An improvised set-up, composed of an atomizer and a hot plate, is used in the experiment. The paper provides evidence of acceptable process repeatability and demonstrates that the technique and the material have important applications in the field of failure analysis. Furthermore, it shows that the application of ARC resulted in better defect localization. The location of the defect is easily been determined upon doing frontside inspection - to - backside image comparison on the deposited unit. By using high kV ion beam passive voltage contrast (PVC) and angled cut focused ion beam (FIB) cross section, we are able to isolate further and show the nature of the defect at the failing block.