Lymphoma of the spermatic cord: Sonographic appearance

Abstract

Primary lymphoma of the spermatic cord is a rare disease accounting for about 1.6% of primary spermatic cord tumors. We hereby present a new case in which color Doppler ultrasound (US), contrast-enhanced US, and MRI suggested a specific diagnosis that was subsequently confirmed pathologically. Color Doppler US revealed mostly hypoechoic, slighly hypervascular tissue surrounding the normal spermatic vessels, which was markedly hypervascular at contrast-enhanced US. MRI showed diffuse infiltration by homogeneously enhancing tissue surrounding the spermatic vessels hypointense to testis on T2-weighted images, isointense on T1-weighed images, lacking fat tissue, with relatively high signal intensity on diffusion-weighted images.

Imaging Features of Paratesticular Masses

“…On sonography, hematopoietic paratesticular tumors appear as hypoechoic homogeneous infiltrative or permeative lesions. Commonly, the vessels are not distorted by the infiltration, which may help differentiate them from other solid firmly growing lesions (Figures and ) …”

Groin abnormalities: ultrasonographic and clinical findings

“…Other primary malignant tumors involving the groin include malignant fibrous histiocytoma, fibrosarcoma, and lymphoma ( Fig. 17) [19].…”

Neoplastic diseases of the spermatic cord: an overview of pathological features, evaluation, and management

“…They can present as unilateral or bilateral masses with or without pain. These non-Hodgkin lymphomas are primary tumors that can be confused with testicular tumors that have extended into the spermatic cord ( 33 ). The most common form is diffuse large B-cell lymphomas reported in patients over 60, with a few reported cases of Burkitt’s lymphoma presenting in a 4-year-old boy and a 20-year-old young man ( 32 - 37 ).…”

“…The most common form is diffuse large B-cell lymphomas reported in patients over 60, with a few reported cases of Burkitt’s lymphoma presenting in a 4-year-old boy and a 20-year-old young man ( 32 - 37 ). A recent study utilized different imaging modalities to characterize a primary spermatic cord tumor and distinguish it from other tumors presenting similarly; they reported preservation of normal funicular vessels, lack of fat within the lesion, as well as homogenous enhancement and intensity on MRI ( 33 ). Imaging is typically followed by radical orchiectomy and immunohistochemistry is utilized to confirm the diagnosis.…”