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Ultrasonographic Analysis of Chronic Intratesticular Pathology

Lynne Blei, MD^*, Cpt Stephen Sihelnik, MC, USA, Maj David Bloom, MC, USA, Col Ray Stutzman, MC, USA and Cpt James Chiadis, MC, USA

^* Department of Radiology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, and the
Departments of Urology, and
Pathology, Walter Reed Army Medical Center, Washington, DC.

Address correspondence and reprint requests to Dr. Blei: 12909 Two Farm Dr, Silver Spring, MD 20904.

Abstract

From our analysis of ultrasound findings and microsopic and gross pathologic features of 23 surgically proven intratesticular lesions, we found five ultrasound criteria to differentiate tumoral, vascular, and inflammatory lesions of the testes. These criteria are 1) markedly increased intratesticular echoes, 2) a rounded anechoic-to-hypoechoic intratesticular lesion, 3) unilateral pathologic features, 4) epididymal involvement, and 5) unilateral, homogeneous increased echogenicity in the testicular parenchyma. The last criterion may be a previously unrecognized ultrasound pattern for granulomatous disease of the testis.

Key Words: scrotal ultrasound • testicular ultrasound • testicular neoplasms • orchitis